scholarly journals Early Internal Branch of Superior Laryngeal Nerve Bifurcation Passes Through Double Thyroid Foramen

2021 ◽  
pp. 014556132110291
Author(s):  
George K. Paraskevas ◽  
Alexandros Poutoglidis ◽  
Nikolaos Lazaridis ◽  
Nikolaos Anastasopoulos ◽  
Nikolaos Tsetsos
Keyword(s):  
Quality Of Life ◽  
Thyroid Gland ◽  
Anatomical Variation ◽  
Superior Laryngeal Nerve ◽  
Anatomical Variations ◽  
Laryngeal Nerve ◽  
Sensory Innervation ◽  
Internal Branch ◽  
Thyrohyoid Membrane

Internal branch of superior laryngeal nerve (ibSLN) provides sensory innervation mostly to the supraglottic part of the larynx and thus prevents aspiration during ingestion. Normally, it is distributed to the larynx after piercing the thyrohyoid membrane above the superior laryngeal artery. Multiple anatomical variations in the course of ibSLN have been reported. An early ibSLN bifurcation and course through double thyroid foramen constitutes an interesting anatomical variation that may easily lead to an injury during procedures in the thyroid gland and the larynx. Knowledge of the anatomical variability is essential in order to prevent surgical complications that could potentially impact the patient’s quality of life.

The Impact of Post-thyroidectomy Paresis on Quality of Life in Patients with Nodular Thyroid Disease

2019 ◽  
Vol 161 (4) ◽  
pp. 589-597 ◽  
Author(s):  
Jesper Roed Sorensen ◽  
Trine Printz ◽  
Jenny Iwarsson ◽  
Ågot Møller Grøntved ◽  
Helle Døssing ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Disease ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
University Hospital ◽  
Specific Patient ◽  
Perceptual Evaluation ◽  
Patient Reported ◽  
The Impact

Objective To investigate the impact of postoperative paresis on disease-specific quality of life (DSQoL) after thyroidectomy in patients with benign nodular thyroid disease. Study Design Observational study. Setting University hospital. Subjects and Methods Patients were evaluated before and 3 weeks and 6 months after surgery in an individual prospective cohort study using videolaryngostroboscopy (VLS), voice range profile, voice handicap index (VHI), multidimensional voice program, maximum phonation time (MPT), and auditory perceptual evaluation. Changes in DSQoL were assessed by the Thyroid-specific Patient-Reported Outcome measure. Cohen’s effect size was used to evaluate changes. Results Sixty-two patients were included, 55 of whom completed all examinations. Three weeks after surgery, a blinded VLS examination showed signs of paresis of either the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve (RLN/EBSLN) in 13 patients (24%). A paresis corresponded to a 12 ± 28 point increase in VHI ( P = .002) and was associated with a significant 4.3 ± 7.5 semitone decrease in the maximum fundamental frequency ( P < .001) and a 5.3 ± 8.2 dB reduction in maximum intensity. Further, it was associated with a 4.5 ± 11.2 second reduction in MPT ( P = .001) and an increase of 0.40 ± 1.19 in grade, 0.42 ± 1.41 in roughness, and 0.36 ± 1.11 in breathiness. Signs of postoperative RLN/EBSLN paresis correlated with an 11.0-point ( P = .02) poorer improvement in goiter symptoms at both 3 weeks and 6 months after surgery. Conclusion Signs of RLN/EBSLN paresis after thyroidectomy were associated with less pronounced improvement in goiter symptoms in patients with thyroid nodular disease. However, thyroidectomy was associated with an overall improved DSQoL by 6 months after surgery.

Thyroid tubercle of Zuckerkandl: anatomical and surgical experience from 79 thyroidectomies

2008 ◽  
Vol 123 (7) ◽  
pp. 768-771 ◽  
Author(s):  
C Page ◽  
P Cuvelier ◽  
A Biet ◽  
P Boute ◽  
M Laude ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Anatomical Variation ◽  
Lateral Lobe ◽  
Anatomical Variations ◽  
Anatomical Landmark ◽  
Laryngeal Nerve ◽  
Surgical Experience ◽  
The Right

AbstractObjective:To highlight a poorly known anatomical variation of the lateral lobe of the thyroid gland, which can be useful in identifying the recurrent laryngeal nerve during thyroid surgery.Materials and methods:We performed a three-year prospective study of 79 thyroid surgery patients. Great attention was paid to anatomical variations of the thyroid gland (i.e. the presence or absence of a distinct tubercle of Zuckerkandl), the recurrent laryngeal nerve and the location of the parathyroid glands.Results:A total of 71 right lobectomies and 74 left lobectomies were performed. Five tubercles of Zuckerkandl were identified (7.04 per cent of cases) and were useful in detecting the recurrent laryngeal nerve (but only on the right side).Conclusion:The tubercle of Zuckerkandl is a poorly known and variable anatomical feature of the thyroid gland which may not, in fact, be so rare. It arises for embryological reasons, and it can be a reliable anatomical landmark for identifying the recurrent laryngeal nerve during thyroid surgery. It should be included in the Nomina Anatomica as the ‘processus posterior glandulae thyroideae’ described by Zuckerkandl.

Microsurgical Anatomy of the Superior and Recurrent Laryngeal Nerves

Neurosurgery ◽  
2001 ◽  
Vol 49 (4) ◽  
pp. 925-933 ◽  
Author(s):  
Ashkan Monfared ◽  
Daniel Kim ◽  
Sivakumar Jaikumar ◽  
Goutham Gorti ◽  
Andrew Kam
Keyword(s):  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Superior Thyroid Artery ◽  
Microsurgical Anatomy ◽  
Anatomic Landmarks ◽  
Internal Branch ◽  
Cricothyroid Muscle ◽  
Thyrohyoid Membrane ◽  
Recurrent Laryngeal Nerves ◽  
The Right

Abstract OBJECTIVE To study the microsurgical anatomy of the superior laryngeal nerve (SLN) and recurrent laryngeal nerve (RLN) with respect to anatomic landmarks, and to identify their vascular supplies. METHODS The microsurgical anatomy of the anterior neck, the course of the right and left SLN and RLN and their variations were studied in 21 cadavers. Fresh cadavers were perfused with colored silicon dye to investigate the microvasculature in detail. RESULTS SLN originates from the inferior vagal ganglion at the C2 level and descends medially toward the thyrohyoid membrane. It branches into an external and an internal branch deep to the internal carotid artery at the C3 level. The external branch, along with the cricothyroid artery, descends deep to the superior thyroid artery toward the cricothyroid muscle. Accompanied by the superior laryngeal artery, the internal branch passes deep to the loop of the superior thyroid artery and pierces the thyrohyoid membrane. Both nerves reside in the fascia covering longus colli muscles and are supplied by their accompanying arteries. The loop of RLN is found at the T1–T3 level on the right, and more caudally at the T3–T6 level on the left, entering the larynx between C5–C7 levels on both sides. RLN receives arterial supply from the esophageal and tracheal branches of the inferior thyroid artery proximally, and by the inferior laryngeal artery distally. CONCLUSION Incidental intraoperative injury to the SLN and RLN potentially could be avoided by understanding the detailed course of each nerve with respect to the surrounding anatomic landmarks and by recognizing their blood supplies.

scholarly journals Correlation : Anatomical Variations of Nasal Cavity and Paranasal Sinuses and the Quality of Life Based on SNOTT-22 Score

2021 ◽  
Vol 17 (1) ◽  
pp. 49-60
Author(s):  
Rani Rahmawati
Keyword(s):  
Quality Of Life ◽  
Ct Scan ◽  
Nasal Cavity ◽  
Paranasal Sinuses ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Paranasal Sinuses Ct ◽  
Snot 22

This study aims to determine the correlation between the anatomical variations of nasal cavity and paranasal sinuses and the quality of life based on SNOT-22 score in the patients who underwent paranasal sinuses CT scan. The samples are 36 patients with age ≥ 18 years. The method is Chi Square test / Fisher's test and Spearman’s rho test. The results showed that anatomical variations of the nasal cavity and paranasal sinuses from most of the patients who underwent paranasal sinuses CT scan had septal deviation n = 29, p = 0.007 (p <0.05) and concha bullosa n = 15, p = 0.029 (p <0.05). There was a significant correlation between total anatomical variation and quality of life based on SNOT-22 score in the patients who underwent paranasal sinuses CT scan p = 0.025 (p <0.05). There was no correlation between the anatomical variations of frontal cells, agger nasi cells, ethmoid bulla, uncinate process and haller cells and the quality of life based on SNOT-22 score in the patients who underwent paranasal sinuses CT scan.  

Neuropeptide Participation in Canine Laryngeal Sensory Innervation

1994 ◽  
Vol 103 (10) ◽  
pp. 767-770 ◽  
Author(s):  
Yasuo Hisa ◽  
Hitoshi Okamura ◽  
Nobuhisa Tadaki ◽  
Jun-Ichi Taguchi ◽  
Toshiyuki Uno ◽  
...  
Keyword(s):  
Substance P ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Sensory Innervation ◽  
Internal Branch ◽  
Nodose Ganglion Neurons ◽  
Calcitonin Gene ◽  
Cholera Toxin Subunit B ◽  
Ganglion Neurons ◽  
Subunit B

We investigated the quantitative participation of calcitonin gene-related peptide (CGRP), substance P (SP), and leu-enkephalin (ENK) in canine laryngeal sensory innervation by immunohistochemistry in combination with retrograde labeling using the recently introduced retrograde tracer cholera toxin subunit B—conjugated gold (CTBG). In the nodose ganglion, neurons labeled from the internal branch of the superior laryngeal nerve with CTBG were investigated immunohistochemically by means of antisera against CGRP, SP, and ENK. The percentages of neurons immunoreactive to each neuropeptide were as follows: CGRP 81.5%, SP 24.5%, and ENK 7.0%. These results suggest that CGRP is the main sensory neurotransmitter in canine laryngeal sensory innervation.

scholarly journals Surgical anatomy of the internal branch of the superior laryngeal nerve

2006 ◽  
Vol 15 (9) ◽  
pp. 1320-1325 ◽  
Author(s):  
Amac Kiray ◽  
Sait Naderi ◽  
Ipek Ergur ◽  
Esin Korman
Keyword(s):  
Superior Laryngeal Nerve ◽  
Surgical Anatomy ◽  
Laryngeal Nerve ◽  
Internal Branch

scholarly journals Upper Airway Nerve Block for Rigid Bronchoscopy in the Patients with Tracheal Stenosis: A Case Serie

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Parviz Amri ◽  
Novin Nikbakhsh ◽  
Seyed Reza Modaress ◽  
Ramin Nosrati
Keyword(s):  
Respiratory Distress ◽  
Nerve Block ◽  
Tracheal Stenosis ◽  
Superior Laryngeal Nerve ◽  
Upper Airway ◽  
Rigid Bronchoscopy ◽  
Laryngeal Nerve ◽  
Intravenous Sedation ◽  
Nerve Blocks

Background: Rigid bronchoscopy is often used to diagnose and treat the location of resection of the tracheal stenosis. It is a selective procedure for the dilatation of tracheal stenosis, especially when accompanied by respiratory distress. Objectives: We introduced patients who were diagnosed with tracheal stenosis and candidate for rigid bronchoscopy dilatation by the upper airway nerve blocks. Methods: This prospective observational study was conducted on 17 patients who underwent dilatation with rigid bronchoscopy in tracheal stenosis at Hospitals affiliated with Babol University of Medical Sciences from 2002 to 2017. The patients were given three nerve blocks, 6 bilateral superior laryngeal nerve block, bilateral glossopharyngeal nerve block, and recurrent laryngeal nerve block (transtracheal) before awake rigid bronchoscopy using 2% lidocaine. We evaluated the demographic data, the cause of tracheal stenosis, the quality of the airway nerve block (Intubation score), patients’ satisfaction from bronchoscopy and thoracic surgeons’ satisfaction. Complications of nerve blocks were recorded. Results: From 2002 to 2017, 17 patients (14 were male and 3 were) female with tracheal stenosis who were candidates for dilatation with bronchoscopy and accepted the upper nerve block were included. The quality of the block was acceptable in 16 (94%) patients. 15 patients received fentanyl, and only two patients did not need to intravenous sedation. The mean age of patients was 29.59 ± 11.59. The average satisfaction of the surgeon was 8.82 ± 1.13 and the satisfaction of patients with anesthesia was 8.89 ± 1.16. There was one serious complication (laryngospasm) in one patient. Conclusions: The upper airway nerve block method is a suitable anesthesia technique for patients with tracheal stenosis who are candidates for the tracheal dilatation with rigid bronoscopy, especially when the patient has respiratory distress and has not been evaluated before surgery.

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