Predictors and consequences of recurrent laryngeal nerve injury during open thyroidectomy: An American College of Surgeons National Surgical Quality Improvement Project database analysis

Twenty patients with vocal fold motion impairment were reviewed to correlate the findings of electromyography (EMG) and stroboscopy. The causes of motion impairment were idiopathic, previous surgery with recurrent laryngeal nerve injury, neck and skull base trauma, and neoplasm. The EMG studies were analyzed to assess the status of innervation of the immobile vocal fold. The presence or absence of the mucosal wave prior to therapeutic intervention was determined with stroboscopic examination. Eight of 10 patients with EMG evidence of reinnervation or partial denervation were found to have mucosal waves, and 3 of 10 patients with EMG evidence of denervation were found to have mucosal waves. Six patients developed mucosal waves after surgical medialization, despite evidence of denervation by EMG criteria. These findings support the premise that tension and subglottic pressure, rather than status of innervation, determine the presence of the mucosal wave.

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Recurrent laryngeal nerve injury in thyroid surgery: a review

ANZ Journal of Surgery ◽

10.1111/j.1445-2197.2012.06247.x ◽

2012 ◽

Vol 83 (1-2) ◽

pp. 15-21 ◽

Cited By ~ 89

Author(s):

Nathan James Hayward ◽

Simon Grodski ◽

Meei Yeung ◽

William R. Johnson ◽

Jonathan Serpell

Keyword(s):

Recurrent Laryngeal Nerve ◽

Nerve Injury ◽

Thyroid Surgery ◽

Recurrent Laryngeal Nerve Injury ◽

Laryngeal Nerve ◽

Laryngeal Nerve Injury

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Observations of recurrent laryngeal nerve injury and recovery using a rat model

The Laryngoscope ◽

10.1002/lary.20293 ◽

2009 ◽

Vol 119 (8) ◽

pp. 1644-1651 ◽

Cited By ~ 28

Author(s):

Belachew Tessema ◽

Rick M. Roark ◽

Michael J. Pitman ◽

Philip Weissbrod ◽

Sansar Sharma ◽

...

Keyword(s):

Recurrent Laryngeal Nerve ◽

Nerve Injury ◽

Rat Model ◽

Recurrent Laryngeal Nerve Injury ◽

Laryngeal Nerve ◽

Laryngeal Nerve Injury

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A current view on recurrent laryngeal nerve injury in total thyroidectomy

Medicina Moderna - Modern Medicine ◽

10.31689/rmm.2021.28.1.7 ◽

2021 ◽

Vol 28 (1) ◽

pp. 7-12

Author(s):

Lucian ALECU ◽

◽

Iulian SLAVU ◽

Adrian TULIN ◽

Vlad BRAGA ◽

...

Keyword(s):

Recurrent Laryngeal Nerve ◽

Total Thyroidectomy ◽

Nerve Injury ◽

Unintentional Injury ◽

Recurrent Laryngeal Nerve Injury ◽

Laryngeal Nerve ◽

Current View ◽

Pubmed Database ◽

Laryngeal Nerve Injury ◽

The Moment

Introduction: Recurrent laryngeal nerve damage during total thyroidectomy was, is, and probably will be in the near future the Achilles’ heel of total thyroidectomy. Material and method: To perform the research we used the PubMed database. The questions were conceived to respect the PICOS guidelines. The PRISMA checklist was used to filter the results. The search was structured following the words: „recurrent laryngeal nerve injury” AND „total thyroidectomy”. Results: A total of 60 papers were identified. We excluded 12 papers as they were duplicates. From the 48 papers left, another 4 could not be obtained. Another 3 papers from the 44 left were excluded due to the fact they were not written in English. One paper was excluded as the subject did not follow our research purpose. 40 papers were left for analysis and discussion. Conclusion: To prevent recurrent laryngeal nerve lesions, at the moment in the literature there is no consensus. Unintentional injury to the recurrent laryngeal nerve is predictable but not an avertible situation thus bilateral lesions still represent a dramatic situation across the world for the patients and the operating surgeon.

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The mechanisms of recurrent laryngeal nerve injury during thyroidectomy and the impact of continuous intraoperative nerve monitoring on surgical strategy

SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital ◽

10.5350/semb.20170227041400 ◽

2017 ◽

pp. 37-42

Author(s):

İsmail Cem Sormaz ◽

İbrahim Fethi Azamat ◽

Fatih Tunca ◽

Yasemin Giles Şenyürek

Keyword(s):

Recurrent Laryngeal Nerve ◽

Nerve Injury ◽

Recurrent Laryngeal Nerve Injury ◽

Laryngeal Nerve ◽

Surgical Strategy ◽

Nerve Monitoring ◽

Laryngeal Nerve Injury ◽

Intraoperative Nerve Monitoring ◽

The Impact

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The impact of the recurrent laryngeal nerve injury on prognosis after McKeown esophagectomy for ESCC

10.21203/rs.3.rs-88872/v1 ◽

2020 ◽

Author(s):

Rirong Qu ◽

Dehao Tu ◽

Wei Ping ◽

Qi Wang ◽

Ni Zhang ◽

...

Keyword(s):

Risk Factors ◽

Recurrent Laryngeal Nerve ◽

Recurrent Laryngeal Nerve Injury ◽

Laryngeal Nerve ◽

Term Survival ◽

Laryngeal Nerve Injury ◽

Independent Risk Factors ◽

Mckeown Esophagectomy ◽

The Impact

Abstract Background: The objective of this study was to assess the impact of the recurrent laryngeal nerve injury (RLNI) after esophagectomy on prognosis.Methods: Retrospectively collected data from 297 patients with esophageal squamous cell carcinoma who underwent McKeown esophagectomy at our department from April 2014 to May 2018, were analyzed.Results: RLNI occurred in 31.9% of the patients. Left-side RLNI occurred 2.8 times more often than right-side RLNI. Among the cases in which assessment of the vocal cords was continued, 8.4% involved permanent injury. There were no significant differences among clinicopathological data between patients with RLNI and without. Compared with patients without RLNI,patients with RNLI have longer operation time,more number of bronchoscopy suctions, longer postoperation hospital stay, and higher incidence of postoperative complications. T stage, N stage, RLN LN metastasis were independent risk factors for the prognosis, but RLNI is not independent risk factors for long-term survival. Conclusion: RLNI is a serious complication that will affect the short-term prognosis of patients and reduce the quality of life of patients. It should be avoided as much as possible during surgery, but it may not have negative impact on the long-term survival.

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