Recurrent Laryngeal Nerve Palsy after Anterior Cervical Discectomy and Fusion – Prevalence and Risk Factors

2020 ◽  
Vol 81 (06) ◽  
pp. 508-512
Author(s):  
Alina Huschbeck ◽  
Michael Knoop ◽  
Adrian Gahleitner ◽  
Stefan Koch ◽  
Thomas Schrom ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Recurrent Laryngeal Nerve ◽  
Body Mass ◽  
Potential Risk ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Duration Of Surgery ◽  
Potential Risk Factors

Abstract Background and Study Aims Recurrent laryngeal nerve palsy (RLNP) is a potential complication of anterior discectomy and fusion (ACDF). There still is substantial disagreement on the actual prevalence of RLNP after ACDF as well as on risk factors for postoperative RLNP. The aim of this study was to describe the prevalence of postoperative RLNP in a cohort of consecutive cases of ACDF and to examine potential risk factors. Materials and Methods This retrospective study included patients who underwent ACDF between 2005 and 2019 at a single neurosurgical center. As part of clinical routine, RLNP was examined prior to and after surgery by independent otorhinolaryngologists using endoscopic laryngoscopy. As potential risk factors for postoperative RLNP, we examined patient's age, sex, body mass index, multilevel surgery, and the duration of surgery. Results 214 consecutive cases were included. The prevalence of preoperative RLNP was 1.4% (3/214) and the prevalence of postoperative RLNP was 9% (19/211). The number of operated levels was 1 in 73.5% (155/211), 2 in 24.2% (51/211), and 3 or more in 2.4% (5/211) of cases. Of all cases, 4.7% (10/211) were repeat surgeries. There was no difference in the prevalence of RLNP between the primary surgery group (9.0%, 18/183) versus the repeat surgery group (10.0%, 1/10; p = 0.91). Also, there was no difference in any characteristics between subjects with postoperative RLNP compared with those without postoperative RLNP. We found no association between postoperative RLNP and patient’s age, sex, body mass index, duration of surgery, or number of levels (odds ratios between 0.24 and 1.05; p values between 0.20 and 0.97). Conclusions In our cohort, the prevalence of postoperative RLNP after ACDF was 9.0%. The fact that none of the examined variables was associated with the occurrence of RLNP supports the view that postoperative RLNP may depend more on direct mechanical manipulation during surgery than on specific patient or surgical characteristics.

scholarly journals Potential Risk Factors for Varicose Veins with Superficial Venous Reflux

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Nazmiye Selçuk Kapısız ◽  
Tülin Uzun Kulaoğlu ◽  
Turgay Fen ◽  
Hasan Fahri Kapısız
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Family History ◽  
Rheumatoid Factor ◽  
Body Mass ◽  
Patient Group ◽  
Potential Risk ◽  
Varicose Veins ◽  
Venous Reflux ◽  
Potential Risk Factors

The objective of the study is to evaluate a range of potential risk factors in the etiology of varicose veins with superficial venous reflux. Forty-nine patients attending a cardiovascular surgery clinic for the management of varicose disease between 2009 and 2010 were enrolled for the study. The age range of the patient group was 44,04 ± 15,05 years and female/male (F/M) ratio was 30/19. Twenty-six normal, healthy volunteers with the age of 40,94 ± 13,60 years and with the female/male ratio of 15/11 acted as control subjects. We investigated several parameters including body mass index, age, birth number > 1, standing for a long time (standing for 8 or more hours without taking a break), systemic diseases, family history, venous Doppler fındings, the levels of homocysteine, ferritin, vitamin B12, and hemoglobin, sedimentation rate, mean corpuscular volume, low density lipoprotein, and rheumatoid factor of the patient group and the control group. We also determined the contribution of the methylene tetrahydrofolate reductase 677 C>T and 1298 A>C gene polymorphisms and FV Leiden in both groups. In this small study, there appears to be no association between varicose veins and body mass index, smoking, type 2 DM, hypertension, family history, and birth number. A history of increased standing duration period (>8 hours) and rheumatoid factor positivity have association with varicose veins with superficial venous reflux.

scholarly journals Comparison of intra-oral mask and classic face mask in terms of ventilation success and practitioners’ work load assessments: a randomized crossover study

2021 ◽  
Author(s):  
Mikail ALKAN ◽  
İsmail Aytaç ◽  
Betül GÜVEN AYTAÇ ◽  
Hidayet ÜNAL ◽  
Bahattin GÜRSUL ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Tidal Volume ◽  
Body Mass ◽  
Potential Risk ◽  
Work Load ◽  
Face Mask ◽  
Mask Ventilation ◽  
Mallampati Score ◽  
Potential Risk Factors

Aim: Providing effective ventilation of the unconscious patient is an essential skill in every specialty dealing with airway management. In this randomized cross-over study aimed to compare intra-oral and classic face mask in terms of ventilation success of patients, practitioners’ workload and anxiety assessments. Also we analyzed potential risk factors of difficult mask ventilation for both masks. Methods: 24 anesthesiology residents and 12 anesthesiologists participated in the study. Each of the practitioners ventilated 4 patients with both masks at settled pressure and frequency. Practitioners rated their workload and anxiety related to masks with National Aeronautics and Space Administration Task Load Index score and State Trait Anxiety Inventory scale. Ventilation success was evaluated with Han scale, expiratory tidal volume and leak volume. We analyzed potential risk factors of difficult mask ventilation with anthropometric characteristics and STOP-BANG score. Results: Ventilation success rate was superior with intraoral mask comparing to classic face mask in terms of Han Scale (Easy mask ventilation percentage 84/144 (58.3%); 123/144 (85.4%); respectively) and tidal volume (481.92±173.99; 430.85±154.87mL; respectively). Leak volume in intraoral mask ventilation was significantly lower than classic face mask (71.50±91.17 /159.38±146.31 respectively). Diffucult mask ventilation risk factors were high weight, neck circumference, Mallampati score and STOP-BANG score>3 for classic face mask (at the utmost neck circumference 95% CI, OR=1.180, p= 0.002) Risk factors were high body mass index and Mallampati score for intraoral mask (at the utmost Body mass index 95% CI, OR=1.162 p=0.006). The anxiety ratings of practitioners were similar between two masks. The work-load rating is higher with intraoral mask comparing to classic face mask. Conclusion: Intraoral mask may be an effective alternative device for bag-valve mask ventilation.

Risk factors predisposing for recurrent laryngeal nerve palsy following thyroid malignancy surgery: experience from a tertiary oncology centre

2020 ◽  
Vol 277 (4) ◽  
pp. 1199-1204 ◽  
Author(s):  
Supreet Singh Nayyar ◽  
Shivakumar Thiagarajan ◽  
Akshat Malik ◽  
Adhara Chakraborthy ◽  
Parthiban Velayutham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Thyroid Malignancy ◽  
Laryngeal Nerve Palsy ◽  
Oncology Centre

scholarly journals Complications of Thyroid Surgery & Their Risk Factors: A Prospective Study at a Tertiary Care Center of Eastern Nepal

2019 ◽  
Vol 2 (1) ◽  
pp. 25-33
Author(s):  
Niranjan Panthi ◽  
S T Chettri ◽  
S P Shah ◽  
D Poudel ◽  
S Manandhar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Recurrent Laryngeal Nerve ◽  
Neck Dissection ◽  
Thyroid Surgery ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Central Compartment ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Palsy

Background: Thyroid surgery is one of the commonest surgeries performed by otolaryngologists. Currently, the main postoperative complications are hypocalcemia and recurrent laryngeal nerve (RLN) palsy. Extent of surgery, lack of identification of RLN/ parathyroid glands, malignancy, central compartment neck dissection, lateral neck dissection, previous surgery and size of goiter are the risk factors for complications. The objectives of this study were to determine the frequency of postoperative complications after thyroid surgery and to analyze the risk factors of complications. Methods: It was a prospective study of 45 patients undergoing thyroid surgery in eastern Nepal from March 2014 to September 2015. The postoperative complications and the risk factors associated with these complications were evaluated. Results: There were total of 45 cases of thyroid surgery, with the mean age of 39.04 years. The main postoperative complications were: hypocalcaemia (6 or 13.33% cases) and vocal cord palsy due to recurrent laryngeal nerve injury (5 or 11.11% cases). Temporary hypocalcaemia was observed in 3(6.67%) cases while permanent hypocalcaemia developed in other 3 (6.67%) cases. Similarly, the temporary and permanent recurrent laryngeal nerve palsy occurred in 3 (6.67%) cases and 2 (4.44%)cases respectively. The risk factors associated with hypocalcaemia were: malignancy, repeat operation, central compartment neck dissection and non-identification of parathyroid glands during surgery. Similarly, recurrent laryngeal nerve palsy was observed in cases of malignancy and central compartment neck dissection. Conclusion: The major postoperative complications of thyroid surgery were hypocalcaemia and recurrent laryngeal nerve palsy. Malignancy and central compartment neck dissection had effect on incidence of complications. Sound knowledge of anatomy and meticulous surgical technique are needed to reduce the incidence of complications.

Risk factors for recurrent laryngeal nerve palsy after thyroidectomy

Open Medicine ◽  
2011 ◽  
Vol 6 (3) ◽  
pp. 279-283 ◽  
Author(s):  
Petr Čelakovský ◽  
Jan Vokurka ◽  
Lukáš Školoudík ◽  
Petr Kordač ◽  
Eva Čermáková
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Thyroid Gland ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Multinodular Goitre ◽  
Laryngeal Nerve Palsy ◽  
Hashimoto's Disease

AbstractThis study investigates the incidence of temporary and permanent recurrent laryngeal nerve palsy (RLNP) and possible risk factors for patients with different types of thyroid gland diseases. 1224 consecutive patients who underwent thyroidectomy for treatment of various thyroid diseases between the years 2001–2005. The rates of RLNP were evaluated. The surgeon and type of thyroid gland disorder were recognised as possible risk factors for RLNP. The incidence of temporary/permanent RLNP for the whole group was 4.5/0.8%. The rates of temporary RLNP for groups, classified as multinodular goitre, Graves’ disease, thyroid cancer or Hashimoto’s disease were 4.3%, 4.3%, 5.2% and 5.7%, respectively. The rates of permanent RLNP for the same groups were 0.4%, 0.9%, 1.6% and 1.9%, respectively. The frequency of temporary RLNP for individual surgeons ranges from 2.8 to 7.0% and the rates of permanent RLNP is between 0–3.1%. There was no relationship between the surgeon’s experience (the number of procedures performed) and RLNP rates. Total thyroidectomy is a safe procedure associated with a low incidence of RLNP not only for benign multinodular goitre, but also for Graves’disease, thyroid cancer and Hashimoto’s disease. The rates of RLNP among individual surgeons are acceptable with small inter-individual differences.

Recurrent laryngeal nerve palsy during surgery for benign thyroid diseases: Risk factors and outcome analysis

Surgery ◽  
2014 ◽  
Vol 155 (3) ◽  
pp. 522-528 ◽  
Author(s):  
Keisuke Enomoto ◽  
Shinya Uchino ◽  
Shin Watanabe ◽  
Yukie Enomoto ◽  
Shiro Noguchi
Keyword(s):  
Risk Factors ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Thyroid Diseases ◽  
Outcome Analysis ◽  
Laryngeal Nerve Palsy ◽  
Benign Thyroid

scholarly journals Study of the Role of Body Mass Index and Serum Leptin as Potential Risk Factors in Patients with Lifelong Premature Ejaculation

2017 ◽  
Vol 7 (3) ◽  
pp. 105-110
Author(s):  
Tarek Tawfik ◽  
Mohamed Aref ◽  
Sameh GamalEl Din ◽  
Mohamed Abd El Mawgood ◽  
Ahmed Khattab
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Body Mass ◽  
Potential Risk ◽  
Premature Ejaculation ◽  
Serum Leptin ◽  
Potential Risk Factors ◽  
Lifelong Premature Ejaculation

scholarly journals Percutaneous iliosacral screw and trans-iliac trans-sacral screw with single C-arm fluoroscope intensifier is a safe treatment for pelvic ring injuries

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Jui-Ping Chen ◽  
Ping-Jui Tsai ◽  
Chun-Yi Su ◽  
I.-Chuan Tseng ◽  
Ying-Chao Chou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Body Mass ◽  
Potential Risk ◽  
Pelvic Ring ◽  
High Body Mass Index ◽  
Medical Institute ◽  
Iliosacral Screw ◽  
Pelvic Ring Injuries ◽  
Potential Risk Factors

AbstractTo elucidate the accuracy, efficacy, and safety of percutaneous iliosacral screw (ISS) and trans-iliac trans-sacral screw (TITS) insertion using a single C-arm fluoroscopy intensifier. Additionally, the potential risk factors that might cause mal-positioned screws were identified. Patients with pelvic ring injuries who underwent percutaneous screw fixation in a single medical institute were divided into an ISS group (n = 59) and a TITS group (n = 62) and assessed. The angles deviated from ideal orientation (ADIO) of the implanted screw were measured, and potential risk factors for mal-positioned screws were analyzed. Overall, the reduction quality of the pelvic ring was good or excellent in 70 patients (82.4%) by Matta’s criteria and in 48 patients (56.5%) by Lefaivre’s criteria. ADIO measurements of the ISS and TITS groups via multi-planar computed tomography were 9.16° ± 6.97° and 3.09° ± 2.8° in the axial view, respectively, and 5.92° ± 3.65° and 2.10° ± 2.01° in the coronal view, respectively. Univariate statistical analysis revealed body mass index as the single potential risk factor of mal-positioned screws. With careful preoperative planning and intraoperative preparations, placing ISS and TITS under the guidance of single C-arm fluoroscopy intensifier is a reliable and safe technique. Caution should be exercised when performing this procedure in patients with a high body mass index.

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