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laryngeal nerve thyroidectomy

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https://www.readbyqxmd.com/read/27867862/intermittent-neural-monitoring-of-the-recurrent-laryngeal-nerve-in-surgery-for-recurrent-goiter
#1
REVIEW
Beata Wojtczak, Marcin Barczyński
Reoperative thyroid surgery is still challenging even for skilled surgeons, and is associated with a higher incidence of complications, such as hypoparathyroidism and recurrent laryngeal nerve (RLN) palsy. Displacement of the RLN, scar tissue from previous neck surgery and difficulty in maintaining good hemostasis are risk factors in reoperations. The prevalence of RLN injury in reoperative thyroid surgery ranges as high as 12.5% for transient injury and up to 3.8% for permanent injury. Bilateral paresis can also occur during reoperations, and is a dangerous complication influencing the quality of life, sometimes requiring tracheostomy...
October 2016: Gland Surgery
https://www.readbyqxmd.com/read/27866716/can-we-consider-immediate-complications-after-thyroidectomy-as-a-quality-metric%C3%A2-of-operation
#2
Jean-Christophe Lifante, Cécile Payet, Fabrice Ménégaux, Frédéric Sebag, Jean-Louis Kraimps, Jean-Louis Peix, François Pattou, Cyrille Colin, Antoine Duclos
BACKGROUND: Permanent recurrent laryngeal nerve palsy and hypoparathyroidism are 2 major complications after thyroid operation. Assuming that the rate of immediate complications can predict the permanent complication rate, some authors consider these complications as a valid metric for assessing the performance of individual surgeons. This study aimed to determine the correlation between rates of immediate and permanent complications after thyroidectomy at the surgeon level. METHODS: We conducted a prospective, cross-sectional study in 5 academic hospitals between April 2008 and December 2009...
November 17, 2016: Surgery
https://www.readbyqxmd.com/read/27846184/minimal-endoscope-assisted-thyroidectomy-through-a-retroauricular-approach-an-evolving-solo-surgery-technique
#3
Myung Jin Ban, Jae Won Chang, Won Shik Kim, Hyung Kwon Byeon, Yoon Woo Koh, Jae Hong Park
This study aimed to evaluate the feasibility and efficacy of minimal endoscope-assisted thyroidectomy (MEAT) through a retroauricular (RA) approach. Most of the thyroidectomy operative time was accounted for by direct visualization through the RA window, minimizing interference between surgical instruments. Endoscope use was minimized and limited to critical surgical aspects, including preservation of the recurrent laryngeal nerve and parathyroid glands. The recurrent laryngeal nerve was neuromonitored throughout the procedure...
November 11, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27818960/vocal-fold-mobility-alteration-reversed-after-thyroidectomy
#4
Aline Paterno Miazaki, Vergilius José Furtado Araújo-Filho, Lenine Garcia Brandão, Vergilius José Furtado de Araujo-Neto, Leandro Luongo Matos, Claudio Roberto Cernea
The involvement of the inferior or recurrent laryngeal nerve (RLN) in mobility derangement of the vocal folds occurs more frequently due to thyroid malignancy invasion. Although uncommon, the same derangement, which is caused by benign thyroid entities, is also described and reverts to normality after a thyroidectomy in up to 89% of cases. In these cases, the pathogenesis of the vocal cord mobility disturbance is attributed to the direct compression of the RLN by massive thyroid enlargement. The authors describe three cases of patients presenting unilateral vocal cord palsy, which, before surgery, was diagnosed by laryngoscopy concomitantly with large and compressive goiter...
July 2016: Autopsy & case reports
https://www.readbyqxmd.com/read/27806782/-modified-minimally-invasive-video-assisted-lateral-neck-dissection-for-papillary-thyroid-carcinoma-a-series-of-130-cases
#5
D G Zhang, L Gao, L Xie, G F He, L Fang, J Chen, Y W Miao, Z Z Wang
Objective: To discuss the feasibility, safety and oncologic completeness of modified minimally invasive video-assisted lateral neck dissection (MIVALND) for papillary thyroid carcinoma. Methods: Data of 130 patients from Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Medical School, Zhejiang University undergoing MIVALND from January 2013 to September 2015 were reviewed retrospectively. There were 31 male and 99 female patients with the mean age of (39±11) years. The thyroidectomy and central compartment dissection were performed under a direct visual field or video-assisted (VA) approach, lateral neck dissection was performed via the VA approach...
November 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27774578/propensity-score-matched-analysis-of-robotic-versus-endoscopic-bilateral-axillo-breast-approach-baba-thyroidectomy-in-papillary-thyroid-carcinoma
#6
Seo Ki Kim, Jung-Woo Woo, Inhye Park, Jun Ho Lee, Jun-Ho Choe, Jung-Han Kim, Jee Soo Kim
PURPOSE: The da Vinci surgical robot system was developed to overcome the weaknesses of endoscopic surgery. However, whether robotic surgery is superior to endoscopic surgery remains uncertain. Therefore, the purpose of this study was to compare the surgical and oncologic outcomes between endoscopic and robotic thyroidectomy using bilateral axillo-breast approach (BABA). METHODS: Between January 2008 and June 2015, papillary thyroid carcinoma patients who underwent thyroidectomy with central neck dissection using endoscopic (n = 480) or robotic (n = 705) BABA were primarily reviewed...
October 24, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27738835/remote-access-robotic-facelift-thyroidectomy-a-multi-institutional-experience
#7
William S Duke, F Christopher Holsinger, Emad Kandil, Jeremy D Richmon, Michael C Singer, David J Terris
BACKGROUND: Robotic facelift thyroidectomy (RFT) was developed as a new surgical approach to the thyroid gland using a remote incision site. Early favorable results led to this confirmatory multi-institutional experience. METHODS: Prospectively collected data on consecutive patients undergoing RFT in five North American academic endocrine surgical practices were compiled. Surgical indications, operative times, final pathology, nodule size, complications, and postoperative management (drain use and length of hospital stay) were evaluated...
October 13, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27737451/a-cost-utility-analysis-of-recurrent-laryngeal-nerve-monitoring-in-the-setting-of-total-thyroidectomy
#8
Daniel J Rocke, David P Goldstein, John R de Almeida
Importance: Intraoperative nerve monitoring (IONM) of the recurrent laryngeal nerve (RLN) is used as a tool to decrease the rate of nerve injury, although study findings are divergent on IONM efficacy. The cost-effectiveness of this approach to total thyroidectomy has not been well studied. Objective: To determine whether IONM is a cost-effective intervention in the setting of total thyroidectomy. Design and Setting: This study creates a decision-tree model of total thyroidectomy to analyze, from a societal perspective, the cost-effectiveness of universal IONM (ie, use in every case) vs selective IONM (ie, high-risk cases including reoperative cases, substernal or toxic goiters, and cases with known cancer) vs no IONM (visual identification only)...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27720825/importance-of-latency-and-amplitude-values-of-recurrent-laryngeal-nerve-during-thyroidectomy-in-diabetic-patients
#9
Ibrahim Ali Ozemir, Ferman Ozyalvac, Gorkem Yildiz, Tunc Eren, Zeynep Aydin-Ozemir, Orhan Alimoglu
BACKGROUND: Diabetes mellitus may cause degeneration in the myelin and/or axonal structures of peripheral nerves. The aim of this study was to investigate the effects of diabetic neuropathy on intraoperative neuromonitoring findings such as latency and amplitude values of the recurrent laryngeal nerves during thyroidectomy. To our knowledge this is the first study to report comparison of the electrophysiologic features of diabetic and non-diabetic patients. MATERIALS AND METHODS: One-hundred-and-eleven consecutive patients who received neuromonitoring during thyroidectomy between 2013 and 2015 were included to study...
October 5, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27682264/intraoperative-neuromonitoring-in-thyroidectomy-the-learning-curve
#10
Paolo Del Rio, Piercosimo Nisi, Sara Benedicenti, Elisa Bertocchi, Enrico Luzietti, Mario Sianesi
AIM: To evaluate the learning curve in the use of intraoperative neuromonitoring of recurrent laryngeal nerve and vagus in thyroid surgery. MATERIALS OF THE STUDY: We analyzed 140 pts treated consecutively for thyroid disease. All the patients were neuromonitored with Intraoperative neuromonitoring of recurrent laryngeal nerve and vagus. We divided these patients in 7 groups to collect the adverse events during our learning curve. RESULTS: We monitored consecutively 271 nerves...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27677707/total-thyroidectomy-versus-thyroid-lobectomy-for-papillary-thyroid-cancer-comparative-analysis-after-propensity-score-matching-a-multicenter-study
#11
Sayaka Kuba, Kosho Yamanouchi, Naomi Hayashida, Shigeto Maeda, Toshiyuki Adachi, Chika Sakimura, Fusako Kawakami, Hiroshi Yano, Megumi Matsumoto, Ryota Otsubo, Shuntaro Sato, Hikaru Fujioka, Tamotsu Kuroki, Takeshi Nagayasu, Susumu Eguchi
BACKGROUND: In patients with papillary thyroid carcinoma (PTC), the role of total thyroidectomy (TT) versus that of thyroid lobectomy (TL) has been controversial. METHODS: This retrospective study was approved by our institutional review board, and the requirement to obtain informed consent was waived. In total, 173 patients with 1- to 5-cm stage cN0 and cM0 PTC tumors treated by curative surgery from 1994 to 2008 were evaluated. Clinicopathologic features and adverse events were compared between patients who underwent TT and those who underwent TL...
September 24, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27659020/influence-of-change-in-surgical-practice-for-benign-thyroid-disease-on-postsurgical-outcome-single-center-experience-in-1400-patients
#12
Urte Kunz-Zurbuchen, Heinz Johannes Buhr, Hubert G Hotz, Martin E Kreis, Kai S Lehmann
PURPOSE: To evaluate the rate of surgical complications during the change from subtotal resection to hemithyroidectomy or thyroidectomy over a period of 17 years. METHODS: All operations for benign goiter at our hospital were analyzed for the periods 1996-2002 (Group 1) and 2003-2012 (Group 2). The groups were compared for recurrent laryngeal nerve damage, hypocalcemia, and other surgical complications directly postoperatively. RESULTS: In total, 1462 patients were operated on for goiter between 1996 and 2012...
September 19, 2016: Asian Journal of Surgery
https://www.readbyqxmd.com/read/27651691/the-tubercle-of-zuckerkandl-an-important-landmark-revisited
#13
Nina Irawati, Richa Vaish, Devendra Chaukar, Anuja Deshmukh, Anil D'Cruz
To study the incidence of the tubercle of Zuckerkandl (ZT) among Indian patients subjected to thyroid surgery at a tertiary care cancer centre and its relevance in localization of recurrent laryngeal nerve (RLN). Prospective study on 144 patients (48 males, 96 females) undergoing thyroidectomy (35 hemithyroidectomies, 109 total thyroidectomies) from September 1st 2010 - February 28th 2013. 144 specimen/253 lobes (129 right, 124 left) were evaluated. Findings were recorded by the same team to ensure consistency...
September 2016: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27651334/recurrent-laryngeal-nerve-management-in-thyroid-surgery-consequences-of-routine-visualization-application-of-intermittent-standardized-and-continuous-nerve-monitoring
#14
Angkoon Anuwong, Matteo Lavazza, Hoon Yub Kim, Che-Wei Wu, Stefano Rausei, Vincenzo Pappalardo, Cesare Carlo Ferrari, Davide Inversini, Andrea Leotta, Antonio Biondi, Feng-Yu Chiang, Gianlorenzo Dionigi
The objective is to compare the consequences of routine visualization (RV) and the application of intermitted (I-IONM), standardized (S-IONM), and continuous monitoring (C-IONM) of recurrent laryngeal nerve (RLN) management. RV includes that 698 RLNs managed solely with visual identification. In a second period 777, RLNs were handled by the I-IONM. The third period 768 RLNs monitoring was performed according to the standards. C-IONM via VN stimulation included 626 RLNs. The following issues were analyzed and compared per each period study: RLN identification rate, branching detection, assessment of NRLN, intraoperative recognizable nerve damage, stage thyroidectomy rate, transient or definitive lesions, bilateral nerve palsy, and recovery time...
September 20, 2016: Updates in Surgery
https://www.readbyqxmd.com/read/27614416/comparative-analysis-between-a-bipolar-vessel-sealing-and-cutting-device-and-the-tie-and-suture-technique-in-thyroidectomy-a%C3%A2-randomized-clinical-trial
#15
K Verónica Chavez, E Manuel Barajas, Jaqueline Ramírez, Juan Pablo Pantoja, Mauricio Sierra, David Velázquez-Fernandez, Miguel F Herrera
BACKGROUND: Advanced bipolar and ultrasonic devices have shown significant reduction in the surgical time of thyroid operations. This randomized, controlled trial assessed if operative time and other relevant outcomes are different for thyroidectomies performed either with a second-generation advanced bipolar device or traditional tie and suture technique. METHODS: Forty-one patients were randomized into 2 groups (advanced bipolar device and traditional tie and suture)...
September 7, 2016: Surgery
https://www.readbyqxmd.com/read/27596752/quantitative-study-of-voice-dysfunction-after-thyroidectomy
#16
James C Lee, Daniel Breen, Amanda Scott, Simon Grodski, Meei Yeung, William Johnson, Jonathan Serpell
BACKGROUND: Up to 80% of patients without a recurrent laryngeal nerve palsy report alteration in their voice after a thyroid procedure. The aims of this study were (1) to quantify voice changes after thyroid operation; (2) to correlate the changes to the extent of operation; and (3) to correlate voice changes to intraoperative recurrent laryngeal nerve swelling. METHODS: Patients undergoing total and hemithyroidectomy were recruited prospectively from the Monash University Endocrine Surgery Unit during a 12-month period...
December 2016: Surgery
https://www.readbyqxmd.com/read/27585396/implementation-of-intraoperative-neuromonitoring-for-transoral-endoscopic-thyroid-surgery-a-preliminary-report
#17
Yong Wang, Xing Yu, Ping Wang, Chundi Miao, Qiuping Xie, Haichao Yan, Qunzi Zhao, Maolin Zhang, Cheng Xiang
BACKGROUND: Transoral endoscopic approach is the natural orifice surgery applied in thyroidectomy to achieve an excellent cosmetic result. Recurrent laryngeal nerve (RLN) injury is the most common complication and little advancement was achieved in the previous clinical studies of transoral thyroid surgery. Herein, we introduced the method of intraoperative neuromonitoring (IONM) for transoral endoscopic thyroid surgery. MATERIALS AND METHODS: Patients with thyroid carcinoma received transoral endoscopic thyroid surgery through vestibular approach (TOETVA) for thyroidectomy and central node dissection (CND)...
September 1, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27578605/safety-of-ligasure-in-recurrent-laryngeal-nerve-dissection-porcine-model-using-continuous-monitoring
#18
Gianlorenzo Dionigi, Feng-Yu Chiang, Hoon Yub Kim, Gregory W Randolph, Alberto Mangano, Pi-Ying Chang, I-Cheng Lu, Yi-Chu Lin, Hui-Chun Chen, Che-Wei Wu
OBJECTIVES/HYPOTHESIS: This study investigated recurrent laryngeal nerve (RLN) real-time electromyography (EMG) data to define optimal safety parameters of the LigaSure Small Jaw (LSJ) instrument during thyroidectomy. STUDY DESIGN: Prospective animal model. METHODS: Dynamic EMG tracings were recorded from 32 RLNs (16 piglets) during various applications of LSJ around using continuous electrophysiologic monitoring. At varying distances from the RLN, the LSJ was activated (activation study)...
August 31, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27538052/risk-of-recurrent-laryngeal-nerve-palsy-in-patients-undergoing-thyroidectomy-with-and-without-intraoperative-nerve-monitoring
#19
A Bergenfelz, A F Salem, H Jacobsson, E Nordenström, M Almquist
BACKGROUND: Vocal cord palsy occurs in 3-5 per cent of patients after thyroidectomy. To reduce this complication, intraoperative nerve monitoring (IONM) has been introduced, although its use remains controversial. This study investigated the risk of postoperative vocal cord palsy with and without the use of intermittent IONM. METHODS: Patients registered in the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery, 2009-2013, were included. Early palsy of the recurrent laryngeal nerve was diagnosed within 6 weeks after surgery...
December 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27521047/routine-central-lymph-node-dissection-with-total-thyroidectomy-for-papillary-thyroid-cancer-potentially-minimizes-level-vi-recurrence
#20
Chad M Hall, Samuel K Snyder, Yolanda Muñoz Maldonado, Terry C Lairmore
BACKGROUND: Treatment strategies for papillary thyroid cancer remain controversial due to the lack of large, randomized controlled trials. The purpose of this study was to review the benefit of routine bilateral central lymph node dissection (CLND) by analyzing local recurrence and complication rates from a single institution over a 15-year period. METHODS: A retrospective, institutional review board-approved review of the Baylor Scott & White Tumor Registry was performed on all patients who underwent operation for papillary thyroid cancer between 2000 and 2015...
October 2016: Surgery
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