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Otolaryngology, laryngeal nerves

Ioannis Vasileiadis, Theodore Karatzas, Georgios Charitoudis, Efthimios Karakostas, Sofia Tseleni-Balafouta, Gregory Kouraklis
Importance: Injury of the recurrent laryngeal nerve (RLN) is one of the most serious complications of thyroid surgery. Intraoperative neuromonitoring (IONM) has been introduced to verify RLN function integrity and may be a helpful adjunct in nerve dissection. Objective: To determine whether the use of IONM can reduce the incidence of RLN injury in patients undergoing total thyroidectomy. Design, Setting, and Participants: This cohort study included 2556 patients who underwent total thyroidectomy between January 2002 and December 2012 in the Department of Otolaryngology-Head and Neck Surgery of Venizeleio General Hospital, Heraklion, Greece...
August 4, 2016: JAMA Otolaryngology—Head & Neck Surgery
Alvaro A Macias, Sunil Eappen, Ilya Malikin, Jeremy Goldfarb, Sharon Kujawa, Paul M Konowitz, Dipti Kamani, Gregory W Randolph
BACKGROUND: Although intraoperative nerve monitoring (IONM) is utilized increasingly, the information on the related anesthesia technique is limited. This study presents an up-to-date clinical algorithm, including setup and troubleshooting of an IONM system, endotracheal tube placement, and anesthetic parameters. To our knowledge, this is the first interdisciplinary collaborative protocol for monitored neck surgery based on the published evidence and clinical experience. METHODS: The Departments of Otolaryngology Head and Neck Surgery, Anesthesiology, and Audiology collaboratively developed a protocol for IONM of the recurrent laryngeal nerve (RLN) based on published evidence and our experience with 3000 patients over a 16-year period...
October 2016: Head & Neck
A J Millington, A Farboud, M A Buchanan, A P Bath
1.Vagus nerve stimulation (VNS) is a valuable treatment for intractable epilepsy. Our case series is from one of the UK's only Otolaryngology Departments performing this procedure. 2.Between 2006 and 2014, fifty-six patients underwent sixty two VNS procedures. These included 51 primary implantations, 2 lead changes, 8 generator replacements (of which 5 were originally implanted elsewhere), and one explantation, with two patients lost to follow up. 3.Over half of our 'primary VNS implantation' patients experienced a reduction in seizure frequency, with many experiencing other benefits...
December 9, 2015: Clinical Otolaryngology
Marcin Barczyński, Gregory W Randolph, Claudio Cernea
OBJECTIVES/HYPOTHESIS: Surgical management of the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomy is complex. We hypothesized that there exist variations in surgical behaviors patterns in the management of the EBSLN during thyroidectomy. STUDY DESIGN: A prospective Web-based anonymous survey ( METHODS: The survey, consisting of 22 questions including surgeon demographics, laryngeal examination before and after surgery, and utilization of intraoperative neuromonitoring (IONM) for the management of the recurrent laryngeal nerve (RLN) and the EBSLN, was sent to 673 surgeons worldwide with known interest in thyroid surgery...
January 2016: Laryngoscope
M A Siddique, M Hossen, J A Khan, M A Hanif
This prospective, cross sectional study was carried out in the Department of Otolaryngology & Head-Neck Surgery, Mymensingh Medical College Hospital, Bangladesh from August 2010 to July 2011. One hundred & twenty eight (128) patients with thyroid swelling who underwent surgery were purposely included. The study was designed to determine the incidence of recurrent laryngeal nerve injury during thyroid surgery. Among the 128 patients, female were predominant 78.90%, majority of the patient were in third decade, 96...
July 2015: Mymensingh Medical Journal: MMJ
Tuan-Jen Fang, Yu-Cheng Pei, Li-Jen Hsin, Wan-Ni Lin, Li-Ang Lee, Hsueh-Yu Li, Alice M K Wong
OBJECTIVES/HYPOTHESIS: Determination of superior laryngeal nerve (SLN) involvement in addition to recurrent laryngeal nerve (RLN) paralysis in patients with unilateral vocal fold paralysis (UVFP) relies on traditional, qualitative laryngeal electromyography (LEMG) examination. It is necessary to develop a quantitative measurement that reflects the degree of denervation of the cricothyroid (CT) muscle. The present study aimed to establish a standard quantitative assessment of CT function in patients with UVFP by measuring the turn frequency...
November 2015: Laryngoscope
Antonia Tse, Bilal Anwar
Schwannomas are peripheral nerve neurogenic tumours and although not common, laryngeal schwannomas can provide a unique challenge in diagnostic and treatment management. There are limited reports in the literature on approaches to management. A 73-year-old lady presented to the otolaryngology department after a MRI scan demonstrated an incidental right supraglottic mass. Further investigations included CT scanning and microlaryngoscopy, which only confirmed the presence of the mass with no histology diagnosis...
2015: Journal of Surgical Case Reports
Emad Kandil, Salah Eldin Mohamed, Ahmed Deniwar, Hossam Mohamed, Paul Friedlander, Rizwan Aslam, Ahmad Saeed, Ibrahim Musa, Gregory Randolph
OBJECTIVE: The aim of the study is to examine the correlation between weight, gender, and race with external branch of superior laryngeal nerve (EBSLN) visualization. Furthermore, we compared normative EBSLN neural-monitoring values to those of the recurrent laryngeal nerve (RLN). STUDY DESIGN: Retrospective study. SETTING: North American tertiary academic hospital. SUBJECTS AND METHODS: A retrospective, institutional review board-approved review was carried out on patients undergoing thyroid surgery by a single surgeon over 3...
August 2015: Laryngoscope
Adrian Harvey, Joan N Vickers, Ryan Snelgrove, Matthew F Scott, Sheila Morrison
BACKGROUND: Long quiet eye (QE) duration is central to expertise in sports, while cognitive "slowing down" has been identified as a perceptual skill possessed by skilled surgeons. Eye-tracking evidence is lacking about the relationship of QE duration to slowing down in surgeons. The aim of this study was to examine QE duration, hand movement time (MT), fixation location, and fixation duration in highly experienced (HE) and less experienced (LE) surgeons. METHODS: A mobile eye tracker and camera recorded coupled gaze and hand movements...
February 2014: American Journal of Surgery
Osa Emohare, Erik Peterson, Nathaniel Slinkard, Seth Janus, Robert Morgan
Study Design Case report. Clinical Question The clinical aim is to report on a previously unknown association between guidewire-assisted pedicle screw insertion and neuropraxia of the recurrent laryngeal nerve (RLN), and how this may overlap with the signs of Tapia syndrome; we also report our approach to the clinical management of this patient. Methods A 17-year-old male patient with idiopathic scoliosis experienced Tapia syndrome after posterior instrumentation and arthrodesis at the level of T1-L1...
October 2013: Evidence-based Spine-care Journal
Liu Yang, Wen Li, Zhe Chen, Xueqi Gan
OBJECTIVE: To explore the clinical anatomy of vagal schwannoma and the methods to preserve the continuity of vagus nerve during tumor resection and postoperative functional rehabilitation methods of the nerve. METHOD: To review 15 cases of vagal schwannoma from 2002.07 to 2011.08 treated in the Department of Otolaryngology, West China Hospital. The operative modality was to strip the tumor while keeping the Schwann membrane almost intact so that to protect the nerve fibers as much as possible...
May 2013: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Giovanni Felisati, Elena Gardella, Paolo Schiavo, Alberto Maria Saibene, Carlotta Pipolo, Manuela Bertazzoli, Valentina Chiesa, Alberto Maccari, Angelo Franzini, Maria Paola Canevini
In 30% of patients with epilepsy seizure control cannot be achieved with medications. When medical therapy is not effective, and epilepsy surgery cannot be performed, vagus nerve stimulator (VNS) implantation is a therapeutic option. Laryngeal patterns in vagus nerve stimulation have not been extensively studied yet. The objective was to evaluate laryngeal patterns in a cohort of patients affected by drug-resistant epilepsy after implantation and activation of a vagus nerve stimulation therapy device. 14 consecutive patients underwent a systematic otolaryngologic examination between 6 months and 5 years after implantation and activation of a vagus nerve stimulation therapy device...
January 2014: European Archives of Oto-rhino-laryngology
Sujana S Chandrasekhar, Gregory W Randolph, Michael D Seidman, Richard M Rosenfeld, Peter Angelos, Julie Barkmeier-Kraemer, Michael S Benninger, Joel H Blumin, Gregory Dennis, John Hanks, Megan R Haymart, Richard T Kloos, Brenda Seals, Jerry M Schreibstein, Mack A Thomas, Carolyn Waddington, Barbara Warren, Peter J Robertson
OBJECTIVE: Thyroidectomy may be performed for clinical indications that include malignancy, benign nodules or cysts, suspicious findings on fine needle aspiration biopsy, dysphagia from cervical esophageal compression, or dyspnea from airway compression. About 1 in 10 patients experience temporary laryngeal nerve injury after surgery, with longer lasting voice problems in up to 1 in 25. Reduced quality of life after thyroid surgery is multifactorial and may include the need for lifelong medication, thyroid suppression, radioactive scanning/treatment, temporary and permanent hypoparathyroidism, temporary or permanent dysphonia postoperatively, and dysphagia...
June 2013: Otolaryngology—Head and Neck Surgery
Yu-Cheng Pei, Tuan-Jen Fang, Hsueh-Yu Li, Alice M K Wong
OBJECTIVES/HYPOTHESIS: The relevance of the cricothyroid (CT) muscle in patients with unilateral vocal fold paralysis (UVFP) remains controversial. To clarify the functional significance of the CT muscle in patients with UVFP, the confounding effect of the severity of recurrent laryngeal nerve injury should be taken into consideration. In the present study, quantitative laryngeal electromyography (LEMG) was used to measure the severity of paralysis of the thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex to allow the functional contribution of the CT muscle to be determined...
January 2014: Laryngoscope
Sapna A Patel, Allen D Hillel, Jonathan Perkins
IMPORTANCE: Disk battery ingestion is common in the pediatric population, with over 50,000 ingestions reported annually. In the upper aerodigestive tract, consequences of such ingestions vary widely from superficial mucosal ulcerations to death from erosion through vital structures. This report describes a battery ingestion complication, vocal cord paralysis, to our knowledge not previously described in the otolaryngology literature. OBSERVATIONS: We describe a patient who presented with biphasic stridor and drooling after upper esophageal disk battery ingestion...
March 2013: JAMA Otolaryngology—Head & Neck Surgery
Adalberto Pacheco, Ignacio Cobeta
In this review we question the current way of handling tackle a problem of chronic cough, especially by the excessive number of patients who can not find complete relief from your cough by anatomical diagnosis of universal use. From the field of Otolaryngology new perspectives arise now considering the larynx as a preferential afferent stimuli cough reflex arc. Also the constitution laryngopharyngeal reflux gas and new approaches to non-acid reflux and the local action of pepsin in laryngeal deserving of a joint review, which can illuminate new ways to handle the problem of chronic refractory cough...
2013: Cough
Süleyman Özdemir, Ülkü Tuncer, Özgür Tarkan, Karahan Kara, Özgür Sürmelioğlu
IMPORTANCE: Treatment of bilateral vocal cord paralysis is a considerable challenge for otolaryngologists. Many surgical techniques have been developed for the management of this entity to eliminate the need for tracheotomy. OBJECTIVE: To evaluate the success of the unilateral carbon dioxide laser endoscopic posterior cordotomy technique for bilateral abductor vocal cord paralysis. DESIGN: A retrospective study. SETTING: A university department of otolaryngology-head and neck surgery...
April 2013: JAMA Otolaryngology—Head & Neck Surgery
Marshall E Smith, Nelson Roy, Dan Houtz
OBJECTIVE: To study the effectiveness of ansa-recurrent laryngeal nerve laryngeal reinnervation to improve glottal incompetence causing dysphonia and dysphagia for children with unilateral vocal fold paralysis. DESIGN We reviewed a series of consecutive cases treated from January 1, 2006, through December 31, 2011. SETTING: Otolaryngology division of a children's hospital. PATIENTS Thirteen children with unilateral vocal fold paralysis. MAIN OUTCOME MEASURES: Surgical complications, parent surrogate quality-of-life measures, global overall assessment of improvement, and auditory perceptual assessment...
December 2012: Archives of Otolaryngology—Head & Neck Surgery
Prakobkiat Hirunwiwatkul, Sutumma Tungkavivachagul
The objective of this work was to compare efficacy and adverse effects between vessel sealing system thyroid lobectomy (VSSL) with the new LigaSure™ Small Jaw Instrument and conventional thyroid lobectomy (CTL). This is a multicenter, randomized and controlled study, conducted in the Department of Otolaryngology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Faculty of Medicine, Chulalongkorn University, Bangkok and Division of Otolaryngology, Sukhothai General Hospital, Sukhothai, Thailand...
July 2013: European Archives of Oto-rhino-laryngology
Daniel J Givens, Jason P Hunt, Brandon G Bentz
BACKGROUND: Patients with parathyroid adenomas (PAs) are commonly encountered in otolaryngology and may present with asymptomatic hypercalcemia. Retropharyngeal hematoma and recurrent laryngeal nerve (RLN) paralysis are less commonly encountered presentations and may be harbingers of a malignant process. METHODS AND RESULTS: We present 2 patients with rare presentations of parathyroid adenoma. The first is a 57-year-old man with retropharyngeal hemorrhage and progressive airway compromise...
September 2013: Head & Neck
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