Impact of the anatomy of laryngeal nerves on intraoperative neuromonitoring results in surgery of thyroid gland and functional results after partial laryngectomies

2018 ◽  
Vol 91 (2) ◽  
pp. 30-37
Author(s):  
Greta Berger ◽  
Bożena Kosztyła - Hojna ◽  
Lech Chyczewski
Keyword(s):  
Thyroid Gland ◽  
Surgical Technique ◽  
Superior Laryngeal Nerve ◽  
Functional Results ◽  
Surgical Anatomy ◽  
Intraoperative Neuromonitoring ◽  
Laryngeal Nerve ◽  
Partial Laryngectomy ◽  
Profound Knowledge ◽  
The Impact

The aim of this work was to describe, interpret and highlight the impact of neuroanatomy in the region of the larynx on intraoperative neuromonitoring (IONM) during thyroidectomy. A rich network of anastomoses of the recurrent laryngeal nerve (RLN) and superior laryngeal nerve (SLN) may have impact on the results of thyroidectomy and partial laryngectomy. Intraoperative neuromonitoring is a useful tool in the armamentarium of a head and neck surgeon but it will never replace profound knowledge of surgical anatomy and good surgical technique.

Impact of the laryngeal nerves anatomy on the intraoperative neuromonitoring results in surgery of thyroid gland and functional results after partial laryngectomies

2018 ◽  
Vol 90 (5) ◽  
pp. 1-5
Author(s):  
Greta Berger ◽  
Bożena Kosztyła-Hojna ◽  
Lech Chyczewski
Keyword(s):  
Thyroid Gland ◽  
Surgical Technique ◽  
Recurrent Laryngeal Nerve ◽  
Superior Laryngeal Nerve ◽  
Functional Results ◽  
Surgical Anatomy ◽  
Intraoperative Neuromonitoring ◽  
Laryngeal Nerve ◽  
Partial Laryngectomy ◽  
The Impact

Goal of this work was to describe, interpret and highlight the impact of neuroanatomy in the region of the larynx on the intraoperative neuromonitoring (IONM) during thyroidectomy. Rich anastomoses network of the recurrent laryngeal nerve (RLN) and superior laryngeal nerve (SLN) may have impact on results of thyroidectomy and partial laryngectomy. Intraoperative neuromonitoring is a useful tool in the armamentarium of the Head and Neck surgeon but it will never replace deep knowledge of surgical anatomy and good surgical technique.

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 Assessment of Relation between External Branch of Superior Laryngeal Nerve & Thyroid Gland- A Cadaveric Study

2020 ◽  
Vol 6 (2) ◽  
pp. 73-76
Author(s):  
Anurag ◽  
Vishnu Gupta
Keyword(s):  
Thyroid Gland ◽  
Cricoid Cartilage ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
The Body ◽  
Superior Thyroid Artery ◽  
Group I ◽  
External Branch ◽  
The Mean ◽  
Group Ii

Background: The thyroid gland is essential for normal growth of the body. This study assessed relation of external branch of superior laryngeal nerve to the superior pole of the thyroid gland. Subjects and Methods: This study was conducted on 25 human cadavers having 50 superior thyroid poles of both genders. Cadavers were classified based on age groups, group I was those with age less than 39 years and group II cadavers were those with age more than 40 years of age. Various measurements were performed on cadavers. Results: 14 cadavers were I group I and 11 were in group II. The mean mass was 67.2 Kgs in group I and 59.5 Kgs in group II, time elapsed after death was 481.5 minutes in group I and 476.4 minutes in group II, mean height was 1.74 meters in group I and 1.69 meters in group II, mean BMI found to be 22.3 kg/m2in group I and 20.1 kg/m2in group II. Height found to be significant between both groups (P< 0.05). The mean distance from EBSLN to cranial point of the thyroid gland was 6.66 mm in group I and 8.96 mm in group II. The mean transverse distance from superior thyroid artery to EBSLN was 3.55 mm in group I and 5.12 mm side in group II. The mean distance of the crossing point between the most cranial point of the thyroid lobe was 6.40 mm in group I and 11.47 mm in group II. The mean distance from the EBSLN to the midline of the neck was 19.80 mm in group I and 18.58 mm in group II. The mean distance from the EBSLN to the midline of the neck on the most cranial point of the cricoid cartilage was 18.77 mm in group I and 17.80 mm in group II. Conclusion: Authors found variation in measurements in left and right side in both group I and group II.

Surgical anatomy of the external branch of the superior laryngeal nerve: a systematic review and meta-analysis

2018 ◽  
Vol 403 (7) ◽  
pp. 811-823 ◽  
Author(s):  
Isaac Cheruiyot ◽  
Vincent Kipkorir ◽  
Brandon Michael Henry ◽  
Jeremiah Munguti ◽  
Roberto Cirocchi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Superior Laryngeal Nerve ◽  
Surgical Anatomy ◽  
Laryngeal Nerve ◽  
External Branch

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.

scholarly journals Chronic Electrical Stimulation of the Superior Laryngeal Nerve in the Rat: A Potential Therapeutic Approach for Postmenopausal Osteoporosis

Biomedicines ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. 369
Author(s):  
Kaori Iimura ◽  
Nobuhiro Watanabe ◽  
Philip Milliken ◽  
Yee-Hsee Hsieh ◽  
Stephen J. Lewis ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Thyroid Gland ◽  
Venous Blood ◽  
Disease Model ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Mineral Density ◽  
Ovx Rats ◽  
Chronic Electrical Stimulation ◽  
Stimulation Of

Electrical stimulation of myelinated afferent fibers of the superior laryngeal nerve (SLN) facilitates calcitonin secretion from the thyroid gland in anesthetized rats. In this study, we aimed to quantify the electrical SLN stimulation-induced systemic calcitonin release in conscious rats and to then clarify effects of chronic SLN stimulation on bone mineral density (BMD) in a rat ovariectomized disease model of osteoporosis. Cuff electrodes were implanted bilaterally on SLNs and after two weeks recovery were stimulated (0.5 ms, 90 microampere) repetitively at 40 Hz for 8 min. Immunoreactive calcitonin release was initially measured and quantified in systemic venous blood plasma samples from conscious healthy rats. For chronic SLN stimulation, stimuli were applied intermittently for 3–4 weeks, starting at five weeks after ovariectomy (OVX). After the end of the stimulation period, BMD of the femur and tibia was measured. SLN stimulation increased plasma immunoreactive calcitonin concentration by 13.3 ± 17.3 pg/mL (mean ± SD). BMD in proximal metaphysis of tibia (p = 0.0324) and in distal metaphysis of femur (p = 0.0510) in chronically SLN-stimulated rats was 4–5% higher than that in sham rats. Our findings demonstrate chronic electrical stimulation of the SLNs produced enhanced calcitonin release from the thyroid gland and partially improved bone loss in OVX rats.

scholarly journals Intraoperative Monitoring of the Recurrent Laryngeal Nerve during Thyroidectomy: A Standardized Approach (Part 1)

2011 ◽  
Vol 3 (3) ◽  
pp. 144-150 ◽  
Author(s):  
Henning Dralle ◽  
Antonio Sitges-Serra ◽  
Peter Angelos ◽  
Manuel C Durán Poveda ◽  
Gianlorenzo Dionigi ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Superior Laryngeal Nerve ◽  
Surgical Anatomy ◽  
Laryngeal Nerve ◽  
Nerve Monitoring ◽  
Visual Identification ◽  
Current State ◽  
Monitoring Procedure ◽  
Intraoperative Nerve Monitoring

ABSTRACT One of the most feared complications in thyroid surgery is injury to the superior laryngeal nerve or recurrent laryngeal nerve. Neural identification during surgery is insufficient to assess nerve injury. Intraoperative nerve monitoring of the vagal nerve and recurrent laryngeal nerve during thyroid surgery is a new adjunct designed to allow better identification of nerves at risk and therefore reduce complications related to their injury. This new working tool does not substitute adequate surgical technique but merely provides the surgeon with an adjunct to routine visual identification and functional assessment. The use of nerve monitoring requires standardization of the monitoring procedure. Pursuant to this, we will discuss in two related articles the current state of the art standardized technique of nerve monitoring in thyroid surgery. The aim of part 1 is to provide a concise overview of nerve monitoring in thyroid surgery and its effectiveness. This will include a brief review of the surgical anatomy of the recurrent laryngeal nerve and the key landmarks used to identify the nerve during surgery. Part 2 will describe how to perform the standardized nerve monitoring in a step by step fashion during thyroid surgery which will diminish variable results and misleading information associated with a nonstandardized nerve monitoring procedure.

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