Intraoperative neural monitoring in thyroid cancer surgery

2013 ◽  
Vol 399 (2) ◽  
pp. 199-207 ◽  
Author(s):  
Gregory W. Randolph ◽  
Dipti Kamani
Keyword(s):  
Thyroid Cancer ◽  
Cancer Surgery ◽  
Neural Monitoring

scholarly journals Learning Curve for Using Intraoperative Neural Monitoring Technology of Thyroid Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Ning Zhao ◽  
Zhigang Bai ◽  
Changsheng Teng ◽  
Zhongtao Zhang
Keyword(s):  
Thyroid Cancer ◽  
Learning Curve ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Cancer Surgery ◽  
Monitoring Technology ◽  
Laryngeal Nerve Injury ◽  
Neural Monitoring

We investigated the learning curve for using intraoperative neural monitoring technology in thyroid cancer, with a view to reducing recurrent laryngeal nerve injury complications. Radical or combined radical surgery for thyroid cancer was performed in 82 patients with thyroid cancer and 147 recurrent laryngeal nerves were dissected. Intraoperative neural monitoring technology was applied and the “four-step method” used to monitor recurrent laryngeal nerve function. When the intraoperative signal was attenuated by more than 50%, recurrent laryngeal nerve injury was diagnosed, and the point and causes of injury were determined. The time required to identify the recurrent laryngeal nerve was 0.5–2 min and the injury rate was 2.7%; injuries were diagnosed intraoperatively. Injury most commonly occurred at or close to the point of entry of the nerve into the larynx and was caused by stretching, tumor adhesion, heat, and clamping. The groups are divided in chronological order; a learning curve for using intraoperative neural monitoring technology in thyroid cancer surgery was generated based on the time to identify the recurrent laryngeal nerve and the number of cases with nerve injury. The time to identify the recurrent laryngeal nerve and the number of injury cases decreased markedly with increasing patient numbers. There is a clear learning curve in applying intraoperative neural monitoring technology to thyroid cancer surgery; appropriate use of such technology aids in the protection of the recurrent laryngeal nerve.

scholarly journals Laryngeal Neural Monitoring during Pediatric Thyroid Cancer Surgery—Is Transcartilage Recording a Preferable Method?

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 4051
Author(s):  
Tzu-Yen Huang ◽  
Hoon-Yub Kim ◽  
Gianlorenzo Dionigi ◽  
I-Cheng Lu ◽  
Pi-Ying Chang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Pediatric Population ◽  
Cancer Surgery ◽  
Signal Quality ◽  
Signal Stability ◽  
Emg Amplitude ◽  
Single Center Study ◽  
Neural Monitoring ◽  
Pediatric Thyroid Cancer

The use of transcartilage (TC) intraoperative neuromonitoring (IONM) in a pediatric population has not been reported. This study evaluated the feasibility and the benefit of using TC-IONM for thyroid cancer surgery in a pediatric population. This retrospective single-center study enrolled 33 pediatric patients who had received an IONM-assisted thyroidectomy. Demographic characteristics, standardized IONM laryngeal examinations and stimulation information (L1-V1-R1-R2-V2-L2) were compared between endotracheal tube (ET) and TC methods. In the 15 cancer patients (30 nerves), TC-IONM provided significant higher electromyography (EMG) amplitude (p < 0.001), signal stability (lower V1/V2 signal correlation, r = 0.955 vs. r = 0.484, p = 0.004), signal quality (higher ratio of V1 or V2 amplitude <500µV, 0.0% vs. 43.8%, p = 0.005) and lower R1-R2p change (7.1% vs. 37.5%, p = 0.049) compared to ET-IONM. In the 18 benign patients (28 nerves), TC-IONM provided significantly higher EMG amplitude (p < 0.001), signal stability (r = 0.945 vs. r = 0.746, p = 0.0324) and non-significant higher signal quality and R1-R2p change. This report is the first to discuss the use of TC-IONM in pediatric thyroid surgery. In contrast with ET-IONM, TC-IONM had superior amplitude, stability and quality of EMG signals, which greatly facilitates the meticulous recurrent laryngeal nerve dissection in pediatric thyroidectomies. The TC-IONM method can be considered a feasible, effective and preferable method of monitored thyroidectomy in pediatric thyroid cancer.

scholarly journals Nanoparticles can improve the positive rate of metastatic lymph node in thyroid cancer surgery

2020 ◽  
Author(s):  
Xindi Su ◽  
Fang Chai ◽  
Benrui Lin ◽  
Lu Qu ◽  
Keyi Liu ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Metastatic Lymph Node ◽  
Cancer Surgery ◽  
Control Group ◽  
Blood Calcium ◽  
Metastatic Lymph ◽  
Positive Rate ◽  
Experimental Group

Abstract Objective. To investigate the application of carbon nanoparticles in lymph node dissection and parathyroid gland protection during thyroid cancer surgery. Subjects and Methods. Retrospective analysis was performed on 282 cases of thyroid cancer surgery in our hospital from 2018 to 2019. All patients underwent total thyroidectomy and cervical central lymph node dissection. Nanocarbon was not used in the control group, but was used in the experimental group. The general situation of the patients, the number of postoperative lymph nodes and the number of metastasis were collected, and the differences between serum parathyroid hormone and blood calcium were compared before and on the 3rd and 30th day after surgery. Results. There was no difference in age, sex and TNM stage between the two groups (P > 0.05). The number of metastatic lymph nodes in the experimental group (9.80 ± 4.80) was different from that in the control group (6.95 ± 3.86) (P < 0.05), and the number of metastatic lymph nodes in the experimental group was different from that in the control group (χ2 = 14.968, P < 0.05). There was no difference in blood calcium and PTH between the two groups before and at 3 and 30 days after surgery (P > 0. 05). Conclusion. The application of carbon nanoparticles in thyroid cancer surgery can significantly increase the number of lymph nodes seized and the positive rate of metastatic lymph node removal, but the protection of parathyroid gland is not obvious.

Centralization trends in thyroid cancer surgery

2011 ◽  
Vol 213 (3) ◽  
pp. S114
Author(s):  
Justin J. Baker ◽  
Michael O. Meyers ◽  
Benjamin F. Calvo ◽  
Jen Jen Yeh ◽  
Karyn B. Stitzenberg
Keyword(s):  
Thyroid Cancer ◽  
Cancer Surgery

scholarly journals Incidence of Hypoparathyroidism After Thyroid Cancer Surgery in South Korea, 2007-2016

JAMA ◽  
2019 ◽  
Vol 322 (24) ◽  
pp. 2441 ◽  
Author(s):  
Song Vogue Ahn ◽  
Joon-Hyop Lee ◽  
Erin Allana Bove-Fenderson ◽  
So Young Park ◽  
Michael Mannstadt ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
South Korea ◽  
Cancer Surgery

scholarly journals American Thyroid Association Statement on Preoperative Imaging for Thyroid Cancer Surgery

Thyroid ◽  
2015 ◽  
Vol 25 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Michael W. Yeh ◽  
Andrew J. Bauer ◽  
Victor A. Bernet ◽  
Robert L. Ferris ◽  
Laurie A. Loevner ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Surgery ◽  
Preoperative Imaging ◽  
American Thyroid Association

scholarly journals Gender and Racial Disparities in Survival After Surgery Among Papillary and Patients With Follicular Thyroid Cancer: A 45-Year Experience

2019 ◽  
Vol 12 ◽  
pp. 117955141986619 ◽  
Author(s):  
Ammar Asban ◽  
Sebastian K Chung ◽  
Rongbing Xie ◽  
Brenessa M Lindeman ◽  
Courtney J Balentine ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Racial Disparities ◽  
Surgical Procedures ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cancer Surgery ◽  
Cancer Type ◽  
Follicular Thyroid Cancer ◽  
Term Care

Background: Demographic disparities have been described for survival after thyroid cancer surgery using national registries and databases. At the institution level, we hypothesized that assessing survival after thyroid cancer surgery in a long-term cohort with diverse gender and racial groups would reveal disparities in survival. Methods: We examined medical records of patients with papillary or follicular thyroid cancer undergoing thyroidectomy, lobectomy, and other surgical procedures from 1971 to 2016 at a tertiary referral center. We obtained information on demographics, cancer stage, procedure, and radioactive iodine (RAI). We measured survival using Kaplan-Meier estimates and Cox proportional hazards models. Results: A total of 1440 (91%) patients with papillary cancer and 144 (9%) patients with follicular thyroid cancer underwent total thyroidectomy (1297, 82%), lobectomy (261, 16.5%), and other surgical procedures (26, 1.5%). Most patients (1131, 71%) were woman, and 909 (57%) were older than 45 years. Race/ethnicity included 805 (51%) white, 161 (10%) African Americans, and 618 (39%) other race/ethnicities. Both 10- and 20-year survival rates in nonwhite males were worse compared with nonwhite females ( P < .0001). After controlling for age, cancer type, stage, surgical procedure, RAI, and year of surgery, nonwhite males had a higher mortality risk compared with nonwhite females ( P = .0376, confidence interval (CI): 1.03-2.43), white males ( P < .0001, CI: 1.88-6.54), and white females ( P < .0001, CI: 3.31-9.90). Conclusions: Our diverse cohort demonstrates significant gender and racial disparities in survival after thyroid cancer surgery. To improve health outcomes and reduce health disparities among nonwhite males, interventions and long-term care management should target potentially modifiable causes of worse outcomes in this group.

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