Thyroidectomy: Prevention of bilateral recurrent nerve palsy, results of identification of the nerve over 23 consecutive years (1946-69) with a description of an additional safety measure

SUMMARY INTRODUCTION: Obesity is a growing public health problem associated with many comorbid diseases. The aim of this study was to evaluate the relationship between body mass index and complications of thyroidectomy. METHODS: Patients who underwent total thyroidectomy between January 2015 and December 2018 were enrolled. Patients were divided into two groups, i.e., BMI <25 (group A) and BMI≥ 25 (group B). Demographics, operative time, and complications were retrospectively reviewed. RESULTS: The study included 145 patients (66 in Group A and 79 in Group B). There was no significant difference between the two groups in terms of age (p=0.330) and gender (p=0.055). No surgical site infection and bleeding complications were observed in any patients. The mean operative time was 148.4 minutes (90-235) in Group A and 153.4 minutes (85-285) in Group B (p=0.399). Transient hypocalcemia was observed in 25 (37.9%) patients in group A, and 23 (29.1%) patients in Group B (p = 0.291). Permanent hypocalcemia was not observed in any patient in group A, and in 2 patients in Group B (2.5%) (p = 0.501). Transient recurrent nerve palsy was observed in 1 (1.5%) patient in Group A and in 3 (3.8%) patients in Group B (p=0.626). None of the patients had permanent recurrent nerve palsy. Parathyroid autotransplantation was performed on 1 patient (1.5%) in group A and on 7 (8.9%) patients in Group B (p=0.055). CONCLUSION: We think there is no relationship between a high BMI and thyroidectomy complications, and surgery can also be performed safely in this patient group.

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Recurrent abducens nerve palsy and hypophosphatasia syndrome

BMJ Case Reports ◽

10.1136/bcr-2018-226895 ◽

2019 ◽

Vol 12 (4) ◽

pp. e226895

Author(s):

Neha Khade ◽

Simon Carrivick ◽

Carolyn Orr ◽

David Prentice

Keyword(s):

Nerve Palsy ◽

Alkaline Phosphatase Level ◽

Abducens Nerve ◽

Recurrent Nerve ◽

Double Vision ◽

Mechanical Compression ◽

Sixth Cranial Nerve ◽

Recurrent Nerve Palsy ◽

Dorello’S Canal ◽

Biochemical Testing

A 47-year-old woman presented with six episodes of horizontal binocular double vision over a 2-year period. CT imaging was significant for extensive dural calcification in the spine and calcification of the skull base, likely involving Dorello’s canal. Biochemical testing revealed a persistently low alkaline phosphatase level. Recurrent nerve palsy may possibly be induced by mechanical compression of the sixth cranial nerve in Dorello’s canal from calcification due to hypophosphatasia syndrome.

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Surgical treatment of Zenker's diverticulum

The Journal of Laryngology & Otology ◽

10.1017/s0022215100112575 ◽

1990 ◽

Vol 104 (4) ◽

pp. 312-314 ◽

Cited By ~ 36

Author(s):

K. Aggerholm ◽

P. Illum

Keyword(s):

Surgical Treatment ◽

Nerve Palsy ◽

Prophylactic Treatment ◽

Infectious Complications ◽

Zenker’S Diverticulum ◽

Recurrent Nerve ◽

Recurrent Nerve Palsy ◽

Zenker's Diverticulum ◽

Local Complications

AbstractOne-hundred-and-fifty patients with Zenker's diverticulum were reviewed; twelve patients received no treatment; 26 patients were treated endoscopically by dilatation, five of these had a diverticulectomy performed at a later stage.One-hundred-and-ten patients had a diverticulectomy performed (a total of 115 primary operations were performed). Eighteen of the patients operated upon had a recurrence and six underwent re-operation.Local complications occurred in 24 patients. Seven patients had a fistula and two had mediastinitis. Ten patients had recurrent nerve palsy, of which five were permanent. Thirteen patients had other complications, usually infection. One death occurred.Post-operative prophylactic treatment with antibiotics was found to significantly reduce the number of local infectious complications and a correlation was found between the occurrence of local, infectious complications and later recurrence of the pouch.

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Intravagal parathyroid adenoma

The Journal of Laryngology & Otology ◽

10.1017/s0022215100109806 ◽

1989 ◽

Vol 103 (7) ◽

pp. 704-706 ◽

Cited By ~ 12

Author(s):

T. Takimoto ◽

Y. Okabe ◽

M. Ito ◽

R. Umeda

Keyword(s):

Vagus Nerve ◽

Parathyroid Adenoma ◽

Calcium Level ◽

Serum Calcium Level ◽

Rare Case ◽

Nerve Palsy ◽

Recurrent Nerve ◽

Surgical Operation ◽

Recurrent Nerve Palsy ◽

Left Vagus

AbstractAn extremely rare case of intravagal parathyroid adenoma is presented. The tumour caused fusiform swelling of the left vagus nerve was shelled out. Post-operatively the left recurrent nerve palsy was recovered in the two months. Serum calcium level returned to normal on the tenth day after the surgical operation without symptoms of hypocalcaemia.

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Successful treatment with positive airway pressure ventilation for tension pneumopericardium after pericardiocentesis in a neonate: a case report

JA Clinical Reports ◽

10.1186/s40981-020-00384-x ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Makiko Tani ◽

Tomoyuki Kanazawa ◽

Naohiro Shioji ◽

Kazuyoshi Shimizu ◽

Tatsuo Iwasaki ◽

...

Keyword(s):

Nerve Palsy ◽

Therapeutic Option ◽

Insertion Site ◽

Upper Airway ◽

Interrupted Aortic Arch ◽

Drainage Tube ◽

Positive Pressure ◽

Recurrent Nerve ◽

Recurrent Nerve Palsy ◽

Hemodynamic Deterioration

Abstract Background Pneumopericardium in neonates is often associated with respiratory diseases, of which positive pressure ventilation (PPV) is an exacerbating factor. Here, we present a neonate case of pneumopericardium after cardiac surgery which was resolved after applying PPV. Case presentation A 28-day-old neonate with left recurrent nerve palsy after aortic reconstruction for interrupted aortic arch developed pericardial effusion. Pericardiocentesis was performed under general anesthesia, and a drainage tube was left in the pericardium. After extubation, stridor gradually exacerbated, following hemodynamic deterioration. A chest X-ray demonstrated pneumopericardium. Upper airway stenosis due to recurrent nerve palsy developed excessive negative pleural pressure, and air was drawn into pericardium via the insertion site of the drainage tube. After tracheal intubation and applying PPV, the pneumopericardium improved. Conclusion PPV does not always exacerbate pneumopericardium. In a patient with pericardial-atmosphere communication, increased inspiration effort can cause pneumopericardium, and PPV is a therapeutic option to alleviate the pneumopericardium.

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Statistical Study of Recurrent Nerve Palsy after Thyroid Cancer Surgery

Koutou (THE LARYNX JAPAN) ◽

10.5426/larynx1989.9.2_150 ◽

1997 ◽

Vol 9 (2) ◽

pp. 150-155 ◽

Cited By ~ 1

Author(s):

Akio Kondo ◽

Kohji Kimoto ◽

Yasuo Koike ◽

Yoshihiro Hashiuchi ◽

Masakatsu Toda ◽

...

Keyword(s):

Thyroid Cancer ◽

Nerve Palsy ◽

Statistical Study ◽

Cancer Surgery ◽

Recurrent Nerve ◽

Recurrent Nerve Palsy

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Surgery of the Thyroid Gland

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2020.47 ◽

1997 ◽

Vol 40 (3) ◽

pp. 71-74

Author(s):

Jan Vokurka ◽

Stanislava Jakoubková ◽

Jaroslav Růžička

Keyword(s):

Thyroid Gland ◽

Surgical Technique ◽

Total Thyroidectomy ◽

Nerve Palsy ◽

Diagnostic Procedure ◽

Postoperative Bleeding ◽

Blood Transfusions ◽

Recurrent Nerve ◽

Recurrent Nerve Palsy ◽

Laryngeal Recurrent Nerve

Since the year 1987 to 1996 all kinds of thyroid surgeries were performed at the ENT Department. Altogether 604 patients underwent 655 surgeries. Total lobectomy or total thyroidectomy represented the most common procedures. Due to a gentle surgical technique, which we call ãpreparationÒ, good results were achieved in the morbidity of laryngeal recurrent nerve (permanent palsy in 0.6%), and in perioperative or postoperative bleeding (0.3% of wound revisions, 0.5% of blood transfusions). Postoperative hypoparythyroidism was found in 4.7% patients. There is no correlation between postoperative hoarseness and laryngeal recurrent nerve palsy. Laryngeal endoscopy immediately after surgery is the most valuable diagnostic procedure.

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