scholarly journals Animal Study to Evaluate the Effect of Carbon Dioxide Insufflation on Recurrent Laryngeal Nerve Function in Transoral Endoscopic Thyroidectomy

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Daqi Zhang ◽  
Shijie Li ◽  
Gianlorenzo Dionigi ◽  
Jiao Zhang ◽  
Chunbo Niu ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Recurrent Laryngeal Nerve ◽  
Animal Study ◽  
Endoscopic Thyroidectomy ◽  
Laryngeal Nerve ◽  
Nerve Function ◽  
Carbon Dioxide Insufflation

Cricotracheal separation: a review and a case with bilateral recovery of recurrent laryngeal nerve function

2006 ◽  
Vol 120 (6) ◽  
pp. 497-501 ◽  
Author(s):  
D J McCrystal ◽  
C Bond
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Unusual Case ◽  
Open Repair ◽  
Laryngeal Nerve ◽  
Clinical Suspicion ◽  
Nerve Function ◽  
Short Term ◽  
High Index Of Suspicion ◽  
Type Of Injury

Cricotracheal separation (CTS) is an uncommon injury, with a high index of suspicion required to establish the diagnosis. Computerized tomography (CT) plays a role in diagnosis but cannot necessarily be relied upon. Bilateral recurrent laryngeal nerve (RLN) palsies are usually associated with this type of injury. We recently treated a patient with CTS in whom one RLN was intact from the time of the injury and the other nerve recovered within three months. Computed tomography was inconclusive.Early open repair of the injury and frequent follow-up examinations led to successful decannulation after six weeks and excellent short-term voice and airway outcomes.A detailed discussion of this unusual case is followed by a review of the current literature on CTS, with particular emphasis on significant management dilemmas and controversies.Clinical suspicion remains more sensitive than investigations in diagnosing CTS. Permanent bilateral RLN palsies are not inevitable following these injuries.

A Standard Approach to Expose the Recurrent Laryngeal Nerve During Endoscopic Thyroidectomy

2012 ◽  
Vol 22 (3) ◽  
pp. 259-263 ◽  
Author(s):  
Shi Chang ◽  
Hui-Huan Tang ◽  
Cun-Chuan Wang ◽  
Le-Du Zhou ◽  
Jin-Dong Li ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Endoscopic Thyroidectomy ◽  
Laryngeal Nerve ◽  
Standard Approach

scholarly journals Endoscopic thyroidectomy versus conventional open thyroidectomy for early differentiated thyroid cancer

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Hoang Hiep Phan ◽  
Keyword(s):  
Thyroid Cancer ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Open Surgery ◽  
Differentiated Thyroid Cancer ◽  
Endoscopic Thyroidectomy ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Injury ◽  
Open Lobectomy

Introduction: Endoscopic thyroidectomy has been applied prudently for malignant thyroid tumors. The aim of our study was to compare the outcomes of endoscopic lobectomy and conventional open lobectomy for early differentiated thyroid cancer. Materials and Methods: From October 2018 to October 2019, 485 patients with early differentiated thyroid cancer underwent thyroid lobectomy in National hospital of Endocrinology enrolled. Of them, 235 patients underwent endoscopic lobectomy (EL) and 250 patients underwent conventional open lobectomy (OL). Results: The mean age of the patients was lower in the EL group (22,3 ± 3,6 years) than in the OL group (31,0 ± 5,8 years, P = 0,013). The ratio female/male was higher in the EL group than in the OL group (12/1 vs 7/1, P = 0,002). The operation time in the EL group was longer than in the OL group (58,4 ± 12,9 vs 42,3 ± 9 minutes, P = 0,014). However, there was no significant differences between EL group and OL group in tumor size (1,2 ± 0,2 vs 1,1 ± 0,6, P = 0,123), blood loss (12,5 ± 0,9 vs 13,6 ± 1,6ml, P = 0,457), postoperative hospital day (4,35 ± 1,4 vs 4,1 ± 1,1 days, P = 0,061), transient hypoparathyroidism (0,85% vs 0,8%, P = 0,431) or transient recurrent laryngeal nerve injury (1,27% vs 1,2%, P = 0,311). The drainage volume in the EL group was higher than in the OL group (75,5 ± 11,4 vs 54,1 ± 10,1ml, P = 0,046). Postoperative bleeding was similar in two groups (0,42% vs 0,4%, P = 0,457). There was no postoperative complications such as permanent recurrent laryngeal nerve injury, tracheal perforation, conversion to open surgery, chyle leak, surgical site infection. Patients in the EL group experienced with less pain than those in the OL group at 1 and 2 days after operation according to a visual analog scale (VAS) (P = 0,047). Wound site numbness is significantly less pronounced in the OL group (p = 0,032). Cosmetically, patients in the EL group were more satisfied than in OL group according to the questionnaire we used (P = 0,021). Conclusions: Endoscopic thyroidectomy for patients with early differentiated thyroid cancer is a safe and effective procedure with excellent cosmetic outcome. Postoperative hospital length stays and complications were similar to conventional open surgery.

scholarly journals Recurrent laryngeal nerve injury in endoscopic surgery for thyroid cancer

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Hoàng Hiệp Phan ◽  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Recurrent Laryngeal Nerve ◽  
Neck Dissection ◽  
Lymph Node Dissection ◽  
Differentiated Thyroid Cancer ◽  
Endoscopic Thyroidectomy ◽  
Central Compartment ◽  
Laryngeal Nerve ◽  
Node Dissection

Tóm tắt Đặt vấn đề: Tổn thương dây thần kinh thanh quản quặt ngược (TQQN) là một biến chứng hay gặp trong phẫu thuật ung thư tuyến giáp. Phẫu thuật nội soi mới được ứng dụng và biến chứng này cũng là một lo ngại với các phẫu thuật viên. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang, theo dõi dọc. Người bệnh được chẩn đoán là ung thư tuyến giáp thể biệt hóa giai đoạn sớm, được điều trị phẫu thuật bằng mổ nội soi tại Bệnh viện Nội tiết trung ương từ tháng 01 năm 2013 đến tháng 9 năm 2016. Kết quả: 95 người bệnh (NB) được chẩn đoán là ung thư tuyến giáp thể biệt hóa giai đoạn sớm được phẫu thuật nội soi theo chỉ định. Tổn thương dây thần kinh TQQN không gặp khi cắt 1 thùy tuyến giáp. Tổn thương dây thần kinh TQQN tạm thời khi cắt toàn bộ tuyến giáp tổn thương là 4,8%, cắt toàn bộ tuyến giáp và nạo vét hạch 1 khoang, 2 khoang và 3 khoang lần lượt là 3,6%, 5,6% và 1/5, tính chung là 5,3%. Tổn thương dây thần kinh TQQN vĩnh viễn (sau mổ 6 tháng) có 1 người bệnh (1,1%), trường hợp này thường là có nhân nằm tại vị trí dây chằng Berry đi vào của dây thần kinh TQQN. Tổn thương dây thần kinh của nhóm nạo vét hạch khoang trung tâm (5,6%) cao hơn so với nạo vét hạch khoang bên (3,6%) sự khác biệt có ý nghĩa thống kê (p=0,015). Liệt dây thần kinh TQQN trong nhóm nạo vét hạch cổ tăng hơn gấp 1,27 lần ở nhóm không nạo vét hạch (p = 0,025). Kết luận: Tỉ lệ tổn thương dây thần kinh TQQN phụ thuộc vào phương pháp phẫu thuật tuyến giáp và có nạo vét hạch cổ hay không. Tỉ lệ này sẽ tăng khi nạo vét hạch, đặc biệt là nạo vét hạch khoang trung tâm. Abstract Background: Recurrent laryngeal nerve (RLN) injury is a common complication in thyroidectomy. Endoscopic thyroidectomy has just been applied for thyroid cancer and RLN injury is also a concern of the surgeons. Materials and Methods: It’s a cross-sectional with longitudinal study. Patients with early differentiated thyroid cancer were enrolled into this study underwent endoscopic thyroidectomy in National hospital of Endocrinology from January 2013 to September 2016. Results: 95 patients with early differentiated thyroid cancer underwent endoscopic thyroidectomy were included. No RLN injury occurred for one lobectomy. Transient RLN injury was 5,3% in total of which was 4,8% after total thyroidectomy (TT), TT with compartment neck dissection were 3,6%; 5,6% and 1/5, respectively. One patient with permanent RLN injury (1,1%) due to the node is located into Berry ligament of RLN. There was a significantly increased risk of RLN injury after TT with central compartment neck dissection compared to TT with lateral compartment neck dissection (5,6% vs 3,6%, p=0,015). RLN injury was significantly higher for TT with lymph node dissection is 1,27 than the group without lymph node dissection (p=0.025). Conclusions: RLN injury rate was significantly influenced by types of thyroidectomy and with/without lymph node dissection. The rate was increased after TT with lymph node dissection, especially central compartment neck dissection. Keywords: Early differentiated thyroid cancer, Endoscopic thyroidectomy.

scholarly journals Efficacy of Intraoperative Single Dose Methylprednisolone on Recurrent Laryngeal Nerve Function After Thyroidectomy

2016 ◽  
Vol 101 (3-4) ◽  
pp. 116-120 ◽  
Author(s):  
Ali Ugur Emre ◽  
Guldeniz Karadeniz Cakmak ◽  
Dilek Karakaya Arpaci ◽  
Sevil Uygun Ilikhan ◽  
Murat Damar
Keyword(s):  
Single Dose ◽  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Recovery Time ◽  
Recovery Period ◽  
Operation Time ◽  
Laryngeal Nerve ◽  
Nerve Function ◽  
Significant Difference ◽  
Group 1

Recurrent laryngeal nerve (RLN) palsy is an important complication of thyroid surgery. Injuries can either be permanent or temporary. Prevention or shortening the recovery period of temporary palsies is an area of interest. Some surgeons prefer to use corticosteroids for this purpose as is used for facial nerve palsies although there are conflicting data in the literature. We aimed to investigate the efficacy of perioperative single dose methylprednisolone on recurrent laryngeal nerve function. A total of 438 nerves under risk in 237 surgeries are investigated in 2 groups. In Group 1, patients are administered a single intraoperative dose of methylprednisolone (1 mg/kg) intravenously for 220 nerves under risk. A total of 218 nerves under risk in Group 2 were operated and followed without methylprednisolone. The demographic data of the patients, operation time, the final pathology reports, incidence of recurrent laryngeal nerve palsy, and recovery time are documented and compared. No statistically significant difference was determined in terms of age, sex distribution, number of nerves under risk, and the operation time between groups. There were 3 unilateral RLNP in each group and the mean recovery time for Group 1 and 2 palsies were 20.4 and 19.8 days, respectively, without statistical significance. The presented data indicates that a single intraoperative dose of steroid does not seem to affect the rate and recovery period of RLNP in thyroid surgery.

Continuous intraoperative monitoring of vagus and recurrent laryngeal nerve function in patients with advanced atrioventricular block

2016 ◽  
Vol 401 (4) ◽  
pp. 551-556 ◽  
Author(s):  
Rick Schneider ◽  
Andreas Machens ◽  
Michael Bucher ◽  
Christoph Raspé ◽  
Konstantin Heinroth ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Atrioventricular Block ◽  
Intraoperative Monitoring ◽  
Laryngeal Nerve ◽  
Nerve Function
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