scholarly journals Laryngeal Neural Monitoring during Pediatric Thyroid Cancer Surgery—Is Transcartilage Recording a Preferable Method?

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 4051
Author(s):  
Tzu-Yen Huang ◽  
Hoon-Yub Kim ◽  
Gianlorenzo Dionigi ◽  
I-Cheng Lu ◽  
Pi-Ying Chang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Pediatric Population ◽  
Cancer Surgery ◽  
Signal Quality ◽  
Signal Stability ◽  
Emg Amplitude ◽  
Single Center Study ◽  
Neural Monitoring ◽  
Pediatric Thyroid Cancer

The use of transcartilage (TC) intraoperative neuromonitoring (IONM) in a pediatric population has not been reported. This study evaluated the feasibility and the benefit of using TC-IONM for thyroid cancer surgery in a pediatric population. This retrospective single-center study enrolled 33 pediatric patients who had received an IONM-assisted thyroidectomy. Demographic characteristics, standardized IONM laryngeal examinations and stimulation information (L1-V1-R1-R2-V2-L2) were compared between endotracheal tube (ET) and TC methods. In the 15 cancer patients (30 nerves), TC-IONM provided significant higher electromyography (EMG) amplitude (p < 0.001), signal stability (lower V1/V2 signal correlation, r = 0.955 vs. r = 0.484, p = 0.004), signal quality (higher ratio of V1 or V2 amplitude <500µV, 0.0% vs. 43.8%, p = 0.005) and lower R1-R2p change (7.1% vs. 37.5%, p = 0.049) compared to ET-IONM. In the 18 benign patients (28 nerves), TC-IONM provided significantly higher EMG amplitude (p < 0.001), signal stability (r = 0.945 vs. r = 0.746, p = 0.0324) and non-significant higher signal quality and R1-R2p change. This report is the first to discuss the use of TC-IONM in pediatric thyroid surgery. In contrast with ET-IONM, TC-IONM had superior amplitude, stability and quality of EMG signals, which greatly facilitates the meticulous recurrent laryngeal nerve dissection in pediatric thyroidectomies. The TC-IONM method can be considered a feasible, effective and preferable method of monitored thyroidectomy in pediatric thyroid cancer.

scholarly journals Thyroid Cancer in the Pediatric Population

Genes ◽  
2019 ◽  
Vol 10 (9) ◽  
pp. 723 ◽  
Author(s):  
Vera A. Paulson ◽  
Erin R. Rudzinski ◽  
Douglas S. Hawkins
Keyword(s):  
Thyroid Cancer ◽  
Pediatric Population ◽  
Medullary Carcinoma ◽  
High Rate ◽  
Molecular Characteristics ◽  
Thyroid Tumors ◽  
Molecular Alterations ◽  
Stage Disease ◽  
Therapeutic Recommendations ◽  
Pediatric Thyroid Cancer

Thyroid cancer is rare in the pediatric population, but thyroid carcinomas occurring in children carry a unique set of clinical, pathologic, and molecular characteristics. In comparison to adults, children more often present with aggressive, advanced stage disease. This is at least in part due to the underlying biologic and molecular differences between pediatric and adult thyroid cancer. Specifically, papillary thyroid carcinoma (which accounts for approximately 90% of pediatric thyroid cancer) has a high rate of gene fusions which influence the histologic subtypes encountered in pediatric thyroid tumors, are associated with more extensive extrathyroidal disease, and offer unique options for targeted medical therapies. Differences are also seen in pediatric follicular thyroid cancer, although there are few studies of non-papillary pediatric thyroid tumors published in the literature due to their rarity, and in medullary carcinoma, which is most frequently diagnosed in the pediatric population in the setting of prophylactic thyroidectomies for known multiple endocrine neoplasia syndromes. The overall shift in the spectrum of histotypes and underlying molecular alterations common in pediatric thyroid cancer is important to recognize as it may directly influence diagnostic test selection and therapeutic recommendations.

scholarly journals Pediatric Thyroid Cancer in Europe: An Overdiagnosed Condition? A Literature Review

Diagnostics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 112 ◽  
Author(s):  
Andreea-Ioana Stefan ◽  
Andra Piciu ◽  
Alexandru Mester ◽  
Dragos Apostu ◽  
Marius Badan ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Pediatric Population ◽  
Genetic Characteristics ◽  
Clinical Presentations ◽  
Therapeutic Guidelines ◽  
Major Interest ◽  
Advanced Stages ◽  
The Impact ◽  
Histopathological Type ◽  
Pediatric Thyroid Cancer

Thyroid neoplastic pathology is the most common form of cancer associated with radiation exposure. The most common histopathological type of thyroid carcinoma is the differentiated thyroid cancer (these include papillary and follicular type), which represents over 90% of all cases, especially affecting girls rather than boys. Although patients are diagnosed in advanced stages as compared to adults, the prognosis of the disease is very good, with a 30-year survival rate of over 95% but post-therapeutic morbidity remains quite high. The treatment is based in particular on the therapeutic guidelines for adults, but as children have some histopathological and genetic characteristics of thyroid cancer, as well as different initial clinical presentations, we decided to review the literature on this pathology among the pediatric population, focusing on cases in Europe. The major interest is the impact of the Chernobyl accident.

scholarly journals Learning Curve for Using Intraoperative Neural Monitoring Technology of Thyroid Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Ning Zhao ◽  
Zhigang Bai ◽  
Changsheng Teng ◽  
Zhongtao Zhang
Keyword(s):  
Thyroid Cancer ◽  
Learning Curve ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Cancer Surgery ◽  
Monitoring Technology ◽  
Laryngeal Nerve Injury ◽  
Neural Monitoring

We investigated the learning curve for using intraoperative neural monitoring technology in thyroid cancer, with a view to reducing recurrent laryngeal nerve injury complications. Radical or combined radical surgery for thyroid cancer was performed in 82 patients with thyroid cancer and 147 recurrent laryngeal nerves were dissected. Intraoperative neural monitoring technology was applied and the “four-step method” used to monitor recurrent laryngeal nerve function. When the intraoperative signal was attenuated by more than 50%, recurrent laryngeal nerve injury was diagnosed, and the point and causes of injury were determined. The time required to identify the recurrent laryngeal nerve was 0.5–2 min and the injury rate was 2.7%; injuries were diagnosed intraoperatively. Injury most commonly occurred at or close to the point of entry of the nerve into the larynx and was caused by stretching, tumor adhesion, heat, and clamping. The groups are divided in chronological order; a learning curve for using intraoperative neural monitoring technology in thyroid cancer surgery was generated based on the time to identify the recurrent laryngeal nerve and the number of cases with nerve injury. The time to identify the recurrent laryngeal nerve and the number of injury cases decreased markedly with increasing patient numbers. There is a clear learning curve in applying intraoperative neural monitoring technology to thyroid cancer surgery; appropriate use of such technology aids in the protection of the recurrent laryngeal nerve.

scholarly journals Pediatric Thyroid Cancer: To Whom Do You Send the Referral?

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4416
Author(s):  
Allison Keane ◽  
Darrin V. Bann ◽  
Meghan N. Wilson ◽  
David Goldenberg
Keyword(s):  
Thyroid Cancer ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
High Volume ◽  
Complication Rates ◽  
Comprehensive Literature Review ◽  
Lower Complication ◽  
General Surgeons ◽  
Definition Of ◽  
Pediatric Thyroid Cancer

Pediatric thyroid cancer is rare, but increasing in annual incidence. Differentiated thyroid cancer in pediatric patients is treated surgically. Pediatric thyroidectomies are performed by general surgeons, otolaryngologists, general pediatric surgeons, and pediatric otolaryngologists. In a comprehensive literature review, we discuss the evidence supporting the importance of surgeon subspecialty and surgeon volume on outcomes for pediatric thyroid cancer patients. Pediatric general surgeons and pediatric otolaryngologists perform most pediatric thyroidectomies. Certain subpopulations specifically benefit from a combined approach of a pediatric surgeon and a high-volume thyroid surgeon. The correlation between high-volume surgeons and lower complication rates in adult thyroid surgery applies to the pediatric population; however, the definition of high-volume for pediatric thyroidectomies requires further investigation. The development of dedicated pediatric thyroid malignancy centers and multidisciplinary or dual-surgeon approaches are advantageous.

Intraoperative neural monitoring in thyroid cancer surgery

2013 ◽  
Vol 399 (2) ◽  
pp. 199-207 ◽  
Author(s):  
Gregory W. Randolph ◽  
Dipti Kamani
Keyword(s):  
Thyroid Cancer ◽  
Cancer Surgery ◽  
Neural Monitoring

scholarly journals Upgraded bidirectional approach video-assisted neck surgery (BAVANS) using a rigid endoscope with variable viewing direction for advanced endoscopic lymph node dissection in thyroid cancer patients

Surgery Today ◽  
2019 ◽  
Vol 50 (7) ◽  
pp. 778-782 ◽  
Author(s):  
Akihiro Nakajo ◽  
Koji Minami ◽  
Yoshiaki Shinden ◽  
Hiroko Toda ◽  
Tadahiro Hirashima ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Neck Surgery ◽  
Cancer Surgery ◽  
High Tech ◽  
Node Dissection ◽  
Video Assisted ◽  
Rigid Endoscope

Abstract In 2011, we developed bidirectional approach video-assisted neck surgery (BAVANS) for endoscopic thyroid cancer surgery. BAVANS combines two different approach pathways at 180 degrees to the cervical lesion for endoscopic thyroidectomy and complete cervical lymphadenectomy. We reported previously that the cranio-caudal approach is extremely useful for endoscopic complete lymph node dissection around the trachea. In 2014, we upgraded the initial BAVANS for better maneuverability and quality of lymph node dissection. A new high-tech rigid endoscope with a variable viewing direction (EndoCAMeleon™), has enabled us to reduce the camera port in the anterior neck while keeping the easy maneuverability and the same quality of central lymph node dissection (LND) as with the initial BAVANS. Endoscopic thyroid cancer surgery is now evolving concurrently with new visual technology.

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