Extra-fascial hemithyreoidectomy

The aim of the study was to improve surgical results of patients having thyroid gland pathology by the development of the surgery method directed to increasing possibility of injury and maintenance of the upper laryngeal nerve integrity. Method of performing extrafascial hemithyreoidectomy with visualization of recurrent nerve, parathyroid gland and upper thyroid artery is presented which is directed to decrease specific complications (vocal fold paresis, hypoparathyreosis) and complications associated with the upper laryngeal nerve injury. Using this method, 166 patients having node pathology of thyroid gland were operated on. This method resulted in decreased number of complications (from 15,0 to 2,6%).

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Identification of recurrent laryngeal nerve: a dilemma in thyroid surgery

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213278 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1450

Author(s):

Atishkumar B. Gujrathi ◽

Harshada S. Kurande ◽

Nishikant Gadpayale ◽

Yogesh Paikrao

Keyword(s):

Thyroid Gland ◽

Recurrent Laryngeal Nerve ◽

Nerve Injury ◽

Thyroid Surgery ◽

Recurrent Laryngeal Nerve Injury ◽

Laryngeal Nerve ◽

Recurrent Nerve ◽

Group A ◽

Laryngeal Nerve Injury ◽

Group B

Background: Surgery of the thyroid gland is one of the most common surgical procedures performed. Recurrent laryngeal nerve injury is the most dreaded complication of thyroid surgery. Hence reducing intraoperative injury is of utmost importance. Routine dissection and identification of the recurrent nerve remain controversial.Methods: This study consists of 70 patients who underwent thyroid surgery. This study was conducted at our institute during the period of 2 years (2018-2020). Patients were evaluated and operated. Patients with thyroid diseases and normal vocal cords were allocated to two groups randomly; in group A the nerve was identified and in group B the nerve was not identified.Results: Most of the patients participating in the study were in the age group of 33-42 years. Male to female disease ratio was 0.13:1. In our study out of 70 patients who underwent thyroid surgery, 18 (25.71%) patients suffered from recurrent laryngeal nerve palsy. Amongst those 18 patients, 2 palsies (5.71%) were in Group A and 16 palsies (45.71%) were in Group B. Recurrent laryngeal nerve most commonly lied posterior to the inferior thyroid artery on both right (65.38%) as well as left side (45.45%). Most commonly injured recurrent laryngeal nerve was the right sided recurrent laryngeal nerve (77.77%).Conclusions: Careful dissection of nerve during thyroid surgery eliminates the risk of recurrent laryngeal nerve injury. A thorough knowledge of thyroid gland, recurrent laryngeal nerve and its anatomical relations and variations is of utmost importance in preserving the recurrent laryngeal nerve in thyroid surgery.

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Automated Quantification of Vocal Fold Motion in a Recurrent Laryngeal Nerve Injury Mouse Model

The Laryngoscope ◽

10.1002/lary.27609 ◽

2018 ◽

Vol 129 (7) ◽

pp. E247-E254 ◽

Cited By ~ 6

Author(s):

Megan M. Haney ◽

Ali Hamad ◽

Emily Leary ◽

Filiz Bunyak ◽

Teresa E. Lever

Keyword(s):

Mouse Model ◽

Recurrent Laryngeal Nerve ◽

Nerve Injury ◽

Vocal Fold ◽

Recurrent Laryngeal Nerve Injury ◽

Laryngeal Nerve ◽

Automated Quantification ◽

Laryngeal Nerve Injury ◽

Vocal Fold Motion

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Nerve Injury During Ultrasound-Guided Thyroid Biopsy—A First Reported Complication of Permanent Vocal Fold Paralysis

Ear Nose & Throat Journal ◽

10.1177/0145561320902855 ◽

2020 ◽

pp. 014556132090285 ◽

Cited By ~ 1

Author(s):

Lyndsay L. Madden ◽

Moeko Nagatsuka ◽

Azeem Z. Vasi ◽

Jayesh Madrecha ◽

Libby J. Smith

Keyword(s):

Nerve Injury ◽

Needle Biopsy ◽

Vocal Fold ◽

Thyroid Nodules ◽

Ultrasound Guidance ◽

Needle Aspiration ◽

Vocal Fold Paralysis ◽

Laryngeal Nerve ◽

Ultrasound Guided ◽

Laryngeal Nerve Injury

Needle biopsy is a well-established component in the evaluation of thyroid nodules. The biopsy is usually performed with an ultrasound guidance and consists of either fine-needle aspiration or core needle biopsy. Although these terms are often used interchangeably, their difference is important. To our knowledge, we discuss the first reported case of biopsy-proven laryngeal nerve injury and permanent vocal fold paralysis following ultrasound-guided core biopsy of the thyroid. We advocate this complication be discussed as part of the consent process.

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Development and characterisation of an experimental recurrent laryngeal nerve injury model for the study of viral gene therapy

The Journal of Laryngology & Otology ◽

10.1017/s0022215107009097 ◽

2007 ◽

Vol 122 (5) ◽

pp. 500-505 ◽

Cited By ~ 3

Author(s):

K Fung ◽

N D Hogikyan ◽

S B Heavner ◽

D Ekbom ◽

E L Feldman

Keyword(s):

Gene Therapy ◽

Recurrent Laryngeal Nerve ◽

Nerve Injury ◽

Vocal Fold ◽

Recurrent Laryngeal Nerve Injury ◽

Laryngeal Nerve ◽

Viral Gene ◽

Viral Gene Therapy ◽

Laryngeal Nerve Injury ◽

The Mean

AbstractObjectives:To develop and characterise an experimental model of recurrent laryngeal nerve injury for the study of viral gene therapy.Methods:Twenty rats underwent unilateral recurrent laryngeal nerve injury. After vocal fold mobility was observed, larynges were serially sectioned, and immunohistochemical techniques were employed to stain for neurofilament and motor endplates in order for a blinded investigator to determine the percentage of nerve–endplate contact, as a histological indicator of an intact neuromuscular connection.Results:All animal procedures resulted in complete, ipsilateral vocal fold paralysis that recovered by three weeks. The mean nerve–endplate contact percentage was 11.6 per cent at one week, 53.9 per cent at two weeks, 88.6 per cent at three weeks, 81.7 per cent at four weeks and 86.6 per cent at five weeks. The differences between results at week one and week three were statistically significant (p < 0.01). The mean nerve–endplate contact percentage on the control side was 86.8 per cent.Conclusions:There was a dramatic, measurable decrease in nerve–endplate contact percentage following crush injury to the recurrent laryngeal nerve. Spontaneous recovery was observed by three weeks post-injury. This model will be used to investigate the potential therapeutic role of viral gene therapy for the treatment of recurrent laryngeal nerve injury.

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Influence of Superior Laryngeal Nerve Injury on Glottal Configuration/Function of Thyroidectomy-Induced Unilateral Vocal Fold Paralysis

Otolaryngology ◽

10.1177/0194599814549740 ◽

2014 ◽

Vol 151 (6) ◽

pp. 996-1002 ◽

Cited By ~ 9

Author(s):

Armando De Virgilio ◽

Ming-Hong Chang ◽

Rong-San Jiang ◽

Ching-Ping Wang ◽

Shang-Heng Wu ◽

...

Keyword(s):

Nerve Injury ◽

Vocal Fold ◽

Superior Laryngeal Nerve ◽

Vocal Fold Paralysis ◽

Laryngeal Nerve ◽

Unilateral Vocal Fold Paralysis ◽

Laryngeal Nerve Injury

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Faculty Opinions recommendation of Postoperative laryngoscopy in thyroid surgery: proper timing to detect recurrent laryngeal nerve injury.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.4517960.4376061 ◽

2010 ◽

Author(s):

Gerhard Friedrich ◽

Georg Hammer

Keyword(s):

Recurrent Laryngeal Nerve ◽

Nerve Injury ◽

Thyroid Surgery ◽

Recurrent Laryngeal Nerve Injury ◽

Laryngeal Nerve ◽

Proper Timing ◽

Laryngeal Nerve Injury

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Long-term voice quality outcome after thyroidectomy without laryngeal nerve injury: a prospective 10 year follow up study

Journal of Communication Disorders ◽

10.1016/j.jcomdis.2021.106109 ◽

2021 ◽

pp. 106109

Author(s):

Evelien D'haeseleer ◽

Wouter Huvenne ◽

Hubert Vermeersch ◽

Iris Meerschman ◽

Kissel Imke ◽

...

Keyword(s):

Nerve Injury ◽

Voice Quality ◽

Laryngeal Nerve ◽

Follow Up Study ◽

Laryngeal Nerve Injury

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Correlation between Stroboscopy and Electromyography in Laryngeal Paralysis

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949310201105 ◽

1993 ◽

Vol 102 (11) ◽

pp. 852-857 ◽

Cited By ~ 11

Author(s):

John Kokesh ◽

Lawrence R. Robinson ◽

Paul W. Flint ◽

Charles W. Cummings

Keyword(s):

Recurrent Laryngeal Nerve ◽

Therapeutic Intervention ◽

Vocal Fold ◽

Recurrent Laryngeal Nerve Injury ◽

Laryngeal Nerve ◽

Previous Surgery ◽

Laryngeal Paralysis ◽

The Status ◽

Laryngeal Nerve Injury ◽

Vocal Fold Motion

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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