scholarly journals PHONATION AFTER RECONSTRUCTION OF RECURRENT LARYNGEAL NERVE IN THE OPERATION OF THYROID CANCER

2004 ◽  
Vol 30 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Hiroyuki YAMADA ◽  
Roji ISHIDA ◽  
Satoshi NAKAMURA ◽  
Hajime ISHINAGA
Keyword(s):  
Thyroid Cancer ◽  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve

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 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.

scholarly journals Clinical Outcomes of T4a Papillary Thyroid Cancer With Recurrent Laryngeal Nerve Involvement: A Retrospective Analysis

2020 ◽  
Author(s):  
Han-Seul Na ◽  
Hyun-Keun Kwon ◽  
Sung-Chan Shin ◽  
Yong-Il Cheon ◽  
Myeonggu Seo ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Papillary Thyroid Cancer ◽  
Recurrence Rate ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Clinical Factors ◽  
Esophageal Invasion

Abstract Preoperative vocal cord palsy (VCP) may indicate locally invasive papillary thyroid cancer (PTC); using this relationship, we evaluated the clinical outcomes and risk factors for recurrence in post-thyroidectomy T4a PTC patients with recurrent laryngeal nerve (RLN) involvement. We retrospectively investigated thyroidectomy patients, recorded their clinical factors, recurrence rate, and pathological findings, and analysed the relationship between recurrence rate and clinical factors. Of 72 patients, 37 (51%) had preoperative VCP and 35 (49%) had normal preoperative vocal cord movement with confirmed intraoperative RLN invasion. Tracheal and esophageal invasion was observed in 13 (18%) and 15 (21%) patients, respectively. Thyroid cancer recurred in 18 (25%) patients over 58 months, resulting in 2 (3%) deaths. Recurrence was not associated with surgical extent, organ invasion, enlarged tumour size, or lymph node infiltration (p > 0.05). The recurrence rate was significantly higher in patients with positive resection margins (p < 0.05). T4a PTC patients with RLN involvement showed a poor prognosis. The recurrence rate was not affected by preoperative VCP, intraoperative detection of RLN invasion, nerve resection, nerve preservation by shaving, lymph node metastasis, or tracheal or esophageal invasion. The most important prognostic factor for recurrence was a positive resection margin.

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.

scholarly journals Endoscopic thyroidectomy versus conventional open thyroidectomy for early differentiated thyroid cancer

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Hoang Hiep Phan ◽  
Keyword(s):  
Thyroid Cancer ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Open Surgery ◽  
Differentiated Thyroid Cancer ◽  
Endoscopic Thyroidectomy ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Injury ◽  
Open Lobectomy

Introduction: Endoscopic thyroidectomy has been applied prudently for malignant thyroid tumors. The aim of our study was to compare the outcomes of endoscopic lobectomy and conventional open lobectomy for early differentiated thyroid cancer. Materials and Methods: From October 2018 to October 2019, 485 patients with early differentiated thyroid cancer underwent thyroid lobectomy in National hospital of Endocrinology enrolled. Of them, 235 patients underwent endoscopic lobectomy (EL) and 250 patients underwent conventional open lobectomy (OL). Results: The mean age of the patients was lower in the EL group (22,3 ± 3,6 years) than in the OL group (31,0 ± 5,8 years, P = 0,013). The ratio female/male was higher in the EL group than in the OL group (12/1 vs 7/1, P = 0,002). The operation time in the EL group was longer than in the OL group (58,4 ± 12,9 vs 42,3 ± 9 minutes, P = 0,014). However, there was no significant differences between EL group and OL group in tumor size (1,2 ± 0,2 vs 1,1 ± 0,6, P = 0,123), blood loss (12,5 ± 0,9 vs 13,6 ± 1,6ml, P = 0,457), postoperative hospital day (4,35 ± 1,4 vs 4,1 ± 1,1 days, P = 0,061), transient hypoparathyroidism (0,85% vs 0,8%, P = 0,431) or transient recurrent laryngeal nerve injury (1,27% vs 1,2%, P = 0,311). The drainage volume in the EL group was higher than in the OL group (75,5 ± 11,4 vs 54,1 ± 10,1ml, P = 0,046). Postoperative bleeding was similar in two groups (0,42% vs 0,4%, P = 0,457). There was no postoperative complications such as permanent recurrent laryngeal nerve injury, tracheal perforation, conversion to open surgery, chyle leak, surgical site infection. Patients in the EL group experienced with less pain than those in the OL group at 1 and 2 days after operation according to a visual analog scale (VAS) (P = 0,047). Wound site numbness is significantly less pronounced in the OL group (p = 0,032). Cosmetically, patients in the EL group were more satisfied than in OL group according to the questionnaire we used (P = 0,021). Conclusions: Endoscopic thyroidectomy for patients with early differentiated thyroid cancer is a safe and effective procedure with excellent cosmetic outcome. Postoperative hospital length stays and complications were similar to conventional open surgery.

Sign in / Sign up

Export Citation Format

Share Document