Challenges in electromyographic endotracheal tube (EMG ETT) placement via awake fibreoptic intubation during emergency thyroidectomy

2021 ◽  
Vol 14 (5) ◽  
pp. e242286
Author(s):  
Fathir Fath Mohammad Iskandar ◽  
Nik Amin Sahid Nik Lah ◽  
Abdul Jabbar Ismail ◽  
Tat Boon Yeap
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Airway Obstruction ◽  
Recurrent Laryngeal Nerve ◽  
Continuous Monitoring ◽  
Fibreoptic Intubation ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Neural Monitoring ◽  
Operating Surgeon

Recurrent laryngeal nerve (RLN) injury is one of the main complications of total thyroidectomy. If the injury is bilateral, total airway obstruction, aphonia and hoarseness of voice could be precipitated. Hence, it is wise for the operating surgeon to be guided by neural monitoring during thyroidectomy. We present a valuable experience handling a middle-aged man with a huge papillary thyroid carcinoma . He needed an urgent thyroidectomy due to obstructive symptoms. We highlight our intraoperative dexterity in handling his surgery in the context of continuous monitoring of RLN using electromyography.

scholarly journals Predictive factors and prognosis for recurrent laryngeal nerve invasion in papillary thyroid carcinoma

2017 ◽  
Vol Volume 10 ◽  
pp. 4485-4491 ◽  
Author(s):  
Wenjie Chen ◽  
Jianyong Lei ◽  
Jiaying You ◽  
Yali Lei ◽  
Zhihui Li ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Recurrent Laryngeal Nerve ◽  
Predictive Factors ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Nerve Invasion

scholarly journals Prognosis of papillary thyroid carcinoma with immediate recurrent laryngeal nerve reconstruction

2017 ◽  
Vol 27 (2) ◽  
pp. 187-191
Author(s):  
Tomohito Fuke ◽  
Hiroyuki Yamada ◽  
Kohei Fukukita ◽  
Mamika Kaneko ◽  
Masahiro Sawa ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Nerve Reconstruction

scholarly journals Impact of Prophylactic Bilateral Central Lymph Nodes Dissection in Patients with Papillary Thyroid Carcinoma; Short Term Outcome

2020 ◽  
pp. 18-25
Author(s):  
Mohammed Farid Elhelbawy ◽  
Ahmed Elgendy ◽  
Ahmed Attia Darwish ◽  
Abd El-Wahhab Hemedah Gad
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Laryngeal Nerve Injury ◽  
Central Lymph

Background: Papillary thyroid carcinoma is the most common thyroid carcinoma. There is a debate on prophylactic removal of central lymph nodes. Some authors advise it to avoid recurrence while other investigators condemn it due to its higher risk of recurrent laryngeal nerve injury and/or hypoparathyroidism. Aim of the Work: The aim of this study was to evaluate the safety and morbidity of central lymph nodes dissection during total thyroidectomy in the management of patients with papillary thyroid carcinoma. Patients and Methods: Twelve patients were confirmed by histopathological evaluation to have papillary thyroid examination. Total thyroidectomy was done through transverse neck incision followed by removal of bilateral central group of lymph nodes. Patients were examined postoperatively for recurrent laryngeal nerve injury or hypoparathyroidism. Follow up was done 6 months later with neck ultrasonography, thyroglobulin and antithyroglobulin antibodies. Results: Thirty four percent of the studied cases proved to have lymph nodes metastasis. temporary hypocalcemia occurred in only one patient in this study and was temporary. Recurrent laryngeal nerve affection happened in 17% of the studied cases and was reversible by medical treatment. No evidence of recurrence happened in the first 6 months after operation. Conclusion: The risk of postoperative recurrent laryngeal nerve injury or hypoparathyroidism is minimal after prophylactic CLND. Postoperative hypocalcemia and recurrent laryngeal nerve injury are usually reversible.

scholarly journals A Novel Scoring System for Predicting the Metastases of Posterior Right Recurrent Laryngeal Nerve Lymph Node Involvement in Patients With Papillary Thyroid Carcinoma by Preoperative Ultrasound

2021 ◽  
Vol 12 ◽  
Author(s):  
Kai-Ning Lu ◽  
Yu Zhang ◽  
Jia-Yang Da ◽  
Tian-han Zhou ◽  
Ling-Qian Zhao ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Prediction Model ◽  
Recurrent Laryngeal Nerve ◽  
Scoring System ◽  
Laryngeal Nerve ◽  
Capsular Invasion ◽  
Papillary Thyroid

ObjectiveOur goal was to investigate the correlation between papillary thyroid carcinoma (PTC) characteristics on ultrasonography and metastases of lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN). There is still no good method for clinicians to judge whether a patient needs LN-prRLN resection before surgery, and we also wanted to establish a new scoring system to determine whether patients with papillary thyroid carcinoma require LN-prRLN resection before surgery.Patients and MethodsThere were 482 patients with right or bilateral PTC who underwent thyroid gland resection from December 2015 to December 2017 recruited as study subjects. The relationship between the PTC characteristics on ultrasonography and the metastases of LN-prRLN was analyzed by univariate and logistic regression analyses. Based on the risk factors identified in univariate and logistic regression analysis, a nomogram-based LN-prRLN prediction model was established.ResultLN-prRLN were removed from all patients, of which 79 had LN-prRLN metastasis, with a metastasis rate of 16.39%. Multivariate logistic regression analysis revealed that LN-prRLN metastasis was closely related to sex, age, blood supply, larger tumors (> 1 cm) and capsular invasion. A risk prediction model has been established and fully verified. The calibration curve used to evaluate the nomogram shows that the consistency index was 0.75 ± 0.065.ConclusionPreoperative clinical data, such as sex, age, abundant blood supply, larger tumor (> 1 cm) and capsular invasion, are positively correlated with LN-prRLN metastasis. Our scoring system can help surgeons non-invasively determine which patients should undergo LN-prRLN resection before surgery. We recommend that LN-prRLN resection should be performed when the score is above 103.1.

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