scholarly journals Left Hemithyroidectomy in Combined Thyroid Cancer with Previous Right Lobe Tumour Surgery: a Clinical Case

2021 ◽  
Vol 11 (1) ◽  
pp. 46-50
Author(s):  
S. P. Muzhikov ◽  
M. Iu. Eremenko
Keyword(s):  
Thyroid Cancer ◽  
Recurrent Laryngeal Nerve ◽  
Clinical Case ◽  
Nodular Goiter ◽  
Laryngeal Nerve ◽  
Thyroid Lobe ◽  
Papillary Cancer ◽  
Extent Of Surgery ◽  
Right Lobe ◽  
Left Thyroid Lobe

Background. Combined thyroid cancer is extremely rare. There is no unified approach currently to the choice of treatment and extent of surgery in combined cancer.Aim. A clinical case description of left hemithyroidectomy for follicular papillary cancer in a patient previously operated for follicular right lobe cancer with right recurrent laryngeal nerve injury.Materials and methods. Patient N., 48 yo, had a routine surgical admission in December 2019 with nodular goiter in left thyroid lobe. Suspicio c-r of left thyroid lobe. Condition after right hemithyroidectomy in 2002, postoperative paresis of right recurrent laryngeal nerve.Results. The patient had a routine surgery upon further examination. Morbid histology corresponded to follicular papillary cancer of left thyroid lobe.Discussion. Combined thyroid cancers are relatively poorly documented, stimulating further case studies. The chosen extent of surgery and iatrogenic injury of right recurrent laryngeal nerve in history are also distinctive of this clinical case.Conclusion. A non-standard extent of surgery is described in a clinical case of combined thyroid cancer complicated by postoperative paresis of right recurrent laryngeal nerve in history.

scholarly journals A METHOD FOR RESTORING VOICE FUNCTION OF THE LARYNX AFTER OPERATIONS FOR THYROID CANCER

2020 ◽  
Vol 75 (3) ◽  
pp. 120-122
Author(s):  
N.V. Kovalenko ◽  
◽  
D.V. Fainshtein ◽  
V.V. Ponomaryev ◽  
A.Yu. Nenarokomov ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Respiratory Failure ◽  
Recurrent Laryngeal Nerve ◽  
Respiratory Function ◽  
Clinical Case ◽  
Vocal Folds ◽  
Laryngeal Nerve ◽  
Main Trunk ◽  
The Russian Federation ◽  
The Voice

The incidence of thyroid cancer in the period from 2008 to 2018 in the Russian Federation increased from 74,8 to 114,1 cases per 100,000 population. The risk of damage to the recurrent laryngeal nerve during primary operations ranges from 0,5 to 23 %, with repeated operations increases to 62 %. The Volgograd regional clinical oncological dispensary uses the technique of intraoperative restoration of the function of the recurrent laryngeal nerve by means of a micro-neural anastomosis with the main trunk of the vagus nerve. We have experience in performing 6 similar operations. The description of this technique is given on the example of a clinical case. The described technique allows you to completely restore the voice and mobility of the vocal folds of the larynx. Respiratory function is fully restored, which makes it possible to avoid the formation of a tracheostomy in case of bilateral nerve damage, and if even unilateral paresis led to decompensated respiratory failure.

INTRAOPERATIVE CONTINUOUS NEUROMONITORING OF LARYNGEAL RECCURENT NERVES IN PATIENTS WITH THYROID CANCER

2019 ◽  
Vol 65 (3) ◽  
pp. 342-348
Author(s):  
Viktor Makarin ◽  
Anna Uspenskaya ◽  
Arseniy Semenov ◽  
Natalya Timofeeva ◽  
Roman Chernikov ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Postoperative Complications ◽  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Intraoperative Neuromonitoring ◽  
Laryngeal Nerve ◽  
Laryngeal Muscles ◽  
Neural Transmission ◽  
Continuous Neuromonitoring ◽  
Surgical Manipulation

Laryngeal muscles paresis ranks second in prevalence of postoperative complications after thyroid surgery. Intraoperative neuromonitoring (IONM) of recurrent laryngeal nerve (RLN) results in reduction of cases with dysphonia and prevents such severe complication as bilateral paresis. Currently there are two types of monitoring: intermittent and continual. When using intermittent IONM surgeon has no opportunity to control electrophysiology state of RLN during intervals between stimulations. In case of continual IONM date on amplitude and latency are available to surgeon in real time every second, allowing him instantly react to any disturbance of neural transmission to prevent its damage by changing surgical manipulation. This work presents the first experience of using continual neuromonitoring of RLN in Russia, the procedure is described in details its safety. It is represented the possibility of prevention of bilateral laryngeal muscles paresis.

scholarly journals Optimal Management of the Unilateral Recurrent Laryngeal Nerve Involvement in Patients with Thyroid Cancer

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2129
Author(s):  
Satoru Miyamaru ◽  
Daizo Murakami ◽  
Kohei Nishimoto ◽  
Narihiro Kodama ◽  
Joji Tashiro ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Recurrent Laryngeal Nerve ◽  
Tumor Resection ◽  
Vocal Folds ◽  
Laryngeal Nerve ◽  
Type I ◽  
Optimal Management ◽  
Reconstruction Procedure ◽  
Vocal Function ◽  
Reconstruction Group

We aimed to determine the optimal management of recurrent laryngeal nerve (RLN) involvement in thyroid cancer. We enrolled 80 patients with unilateral RLN involvement in thyroid cancer between 2000 and 2016. Eleven patients with preoperatively functional vocal folds (VFs) underwent sharp tumor resection to preserve the RLN (shaving group). Thirty-three patients underwent RLN reconstruction with RLN resection (reconstruction group). We divided the reconstruction group into two subgroups based on preoperative VF mobility (normal-reconstruction and paralyzed-reconstruction subgroups). In the cases where RLN reconstruction was difficult, phonosurgeries including arytenoid adduction (AA), with or without thyroplasty type I, or nerve muscle pedicle implantation with AA were performed later (phonosurgery group). We evaluated and compared vocal function among the evaluated periods and different groups. Postoperative vocal function in the shaving and normal-reconstruction subgroups was favorable. There were no significant differences between the two groups. In the paralyzed-reconstruction and phonosurgery groups, postoperative vocal function was significantly improved, and vocal function in the paralyzed-reconstruction subgroup was significantly better than that in the phonosurgery group. For optimal management of unilateral RLN involvement in thyroid cancer, first, sharp dissection should be performed, and if this is impossible, a simultaneous RLN reconstruction procedure should be adopted whenever possible.

P-207 Recurrent Laryngeal Nerve Invasion as an Independent Determinant of Complications and Outcome in Papillary Thyroid Cancer

Oral Oncology ◽  
2021 ◽  
Vol 118 ◽  
pp. 5
Author(s):  
Chiu Ho Quentin Mak ◽  
Chrysostomos Tornari ◽  
Noah Evans Harding ◽  
Daria Andreeva ◽  
Iain James Nixon ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Recurrent Laryngeal Nerve ◽  
Papillary Thyroid Cancer ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Nerve Invasion ◽  
Independent Determinant

scholarly journals Non-recurrent inferior laryngeal nerve: a case report

2020 ◽  
Vol 7 (10) ◽  
pp. 3469
Author(s):  
Shah Urvin Manish ◽  
Boopathi Subbarayan ◽  
Saravanakumar Subbaraj ◽  
Tirou Aroul Tirougnanassambandamourty ◽  
S. Robinson Smile
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nodular Goiter ◽  
Anatomical Variations ◽  
Laryngeal Nerve ◽  
Anatomical Landmarks ◽  
Inferior Laryngeal Nerve ◽  
Nonrecurrent Inferior Laryngeal Nerve ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
The Right

The incidence of Non-recurrent laryngeal nerve (NRLN) is reported to be 0.6%-0.8% on the right side and in 0.004% on the left side. Damage to this nerve during thyroidectomy may lead to vocal cord complications and should therefore be prevented. A middle-aged woman with a nodular goiter who underwent subtotal thyroidectomy for multinodular colloid goiter. We encountered a non-recurrent laryngeal nerve on the right side in a patient during surgery. We were not able to find the inferior laryngeal nerve in its usual position using the customary anatomical landmarks. Instead, it was emerging directly from the right vagus nerve at a right angle and entering the larynx as a unique non-bifurcating nerve. Nonrecurrent inferior laryngeal nerve incidence is very rare, but when present, increases the risk of damage during thyroidectomy. Hence, it is very important to be aware of the anatomical variations of the inguinal lymph node (ILN) and the use of safe meticulous dissection while looking for the nerve during thyroidectomy. The use of Intra-operative neuro-monitoring (IONM) if available in thyroid surgery allows the surgeon to recognize and differentiate branches of the inferior laryngeal nerve (ILN) from sympathetic anastomoses, as well as NRLN during surgery.

scholarly journals The Identification of Recurrent Laryngeal Nerve by Injection of Blue Dye into the Inferior Thyroid Artery in Elusive Locations

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Gulcin Hepgul ◽  
Meltem Kucukyilmaz ◽  
Oguz Koc ◽  
Yigit Duzkoylu ◽  
Yavuz Selim Sari ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Potential Risk ◽  
Gold Standard ◽  
Laryngeal Nerve ◽  
Inferior Thyroid Artery ◽  
Surrounding Tissue ◽  
Blue Dye ◽  
Thyroid Lobe ◽  
Tracheoesophageal Groove ◽  
Nerve Localization

Introduction. Thyroidectomy creates a potential risk for all parathyroid glands and the recurrent laryngeal nerve (RLN). The identification and dissection of the RLN is the gold standard for preserving its function. In some cases, it may be quite difficult to identify the nerve localization. In such elusive locations, we aimed to identify RLNs using peroperative injection of a blue dye into the inferior thyroid artery.Materials and Methods. This study included 10 selected patients whose RLN identification had been difficult peroperatively during the period from April 2008 to June 2009. When the RLNs became elusive in location, the branches of the inferior thyroid artery (ITA) on the capsule of the thyroid lobe were isolated, and then 0.5 mL isosulphan blue dye was injected into the artery.Results. RLN was carefully dissected in the tracheoesophageal groove. RLN was clearly visualized, in all patients. All RLNs were identified along their course in the dyed surrounding tissue. No RLN palsy was encountered.Conclusion. The injection of blue dye into the ITA branches can be used as an alternate method in case of difficulty in identification of RLNs.

scholarly journals The Role of Immediate Recurrent Laryngeal Nerve Reconstruction for Thyroid Cancer Surgery

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Tetsuji Sanuki ◽  
Eiji Yumoto ◽  
Ryosei Minoda ◽  
Narihiro Kodama
Keyword(s):  
Thyroid Cancer ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Fold ◽  
Muscle Tone ◽  
Voice Quality ◽  
Laryngeal Nerve ◽  
Cancer Surgery ◽  
Type I ◽  
Nerve Reconstruction ◽  
Normal Ranges

Unilateral vocal fold paralysis (UVFP) is one of the most serious problems in conducting surgery for thyroid cancer. Different treatments are available for the management of UVFP including intracordal injection, type I thyroplasty, arytenoid adduction, and laryngeal reinnervations. The effects of immediate recurrent laryngeal nerve (RLN) reconstruction during thyroid cancer surgery with or without UVFP before the surgery were evaluated with videostroboscopic, aerodynamic, and perceptual analyses. All subjects experienced postoperative improvements in voice quality. Particularly, aerodynamic analysis showed that the values for all patients entered normal ranges in both patients with and without UVFP before surgery. Immediate RLN reconstruction has the potential to restore a normal or near-normal voice by returning thyroarytenoid muscle tone and bulk seen with vocal fold denervation. Immediate RLN reconstruction is an efficient and effective approach to the management of RLN resection during surgery for thyroid cancer.

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