External branch of the superior laryngeal nerve monitoring during thyroid and parathyroid surgery: International Neural Monitoring Study Group standards guideline statement

2013 ◽  
Vol 123 ◽  
pp. S1-S14 ◽  
Author(s):  
Marcin Barczyński ◽  
Gregory W. Randolph ◽  
Claudio R. Cernea ◽  
Henning Dralle ◽  
Gianlorenzo Dionigi ◽  
...  
Keyword(s):  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Study Group ◽  
Parathyroid Surgery ◽  
Nerve Monitoring ◽  
External Branch ◽  
Monitoring Study ◽  
Neural Monitoring

Anterior laryngeal electrodes for recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: New expanded options for neural monitoring

2018 ◽  
Vol 128 (12) ◽  
pp. 2910-2915 ◽  
Author(s):  
Whitney Liddy ◽  
Bradley R. Lawson ◽  
Samuel R. Barber ◽  
Dipti Kamani ◽  
Mohamed Shama ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Parathyroid Surgery ◽  
Nerve Monitoring ◽  
Neural Monitoring ◽  
Recurrent Laryngeal Nerve Monitoring

scholarly journals Improving classification of the external branch of the superior laryngeal nerve with neural monitoring: a research appraisal and narrative review

Gland Surgery ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 2847-2860
Author(s):  
Yishen Zhao ◽  
Zihan Zhao ◽  
Daqi Zhang ◽  
Yujia Han ◽  
Gianlorenzo Dionigi ◽  
...  
Keyword(s):  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Narrative Review ◽  
External Branch ◽  
Neural Monitoring

scholarly journals Recurrent and superior laryngeal nerve injury in thyroid surgery: literature review

2021 ◽  
Author(s):  
Abdullatif Mahyoub ◽  
Alaa A. Aljohani ◽  
Abdullah J. Althobaiti ◽  
Sami S. Alharbi ◽  
Abdulaziz A. Alahmary ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nerve Injury ◽  
Superior Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Nerve Monitoring ◽  
External Branch ◽  
Surgeon Experience ◽  
Laryngeal Nerve Injury ◽  
Intraoperative Nerve Monitoring

Laryngeal nerve injury is considered one of the most common complications after thyroidectomy. It is associated with decreased quality of life because it will result in hoarseness of voice and aspiration. Identification of the risk factors and procedures to decrease the injury is crucial for handling laryngeal nerve injury. We searched the MEDLINE database using PubMed. Two independent reviewers reviewed the resulting papers and reviewed them based on our inclusion criteria. Based on the review results, the incidence of recurrent laryngeal nerve injury is higher than the external branch of the superior laryngeal nerve, but it is mainly due to under-reporting of the external branch of superior laryngeal nerve injury. Cancer surgery, surgeon experience, workload, re-operative procedures, and extent of surgery increased the incidence of the laryngeal nerve injury. Handling of these risk factors combined with visual dissection and inspection and/or intraoperative nerve monitoring decreased the incidence of the nerve injury. In conclusion, laryngeal nerve injury is a common post thyroidectomy complication. Anatomical dissection and visual inspection combined with intraoperative nerve monitoring is the most suitable option in high-risk thyroid surgeries.

scholarly journals Can we routinely identify the external branch of the superior laryngeal nerves with neural monitoring?: a prospective report on 176 consecutive nerves at risk

2021 ◽  
Author(s):  
Paolo Del Rio ◽  
Elena Bonati ◽  
Tommaso Loderer ◽  
Matteo Rossini ◽  
Federico Cozzani
Keyword(s):  
Voice Quality ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Muscle Twitch ◽  
Cricothyroid Muscle ◽  
Emg Signal ◽  
External Branch ◽  
Mode Of Application ◽  
Neural Monitoring ◽  
Intermittent Mode

AbstractThe external branch of the superior laryngeal nerve (EBSLN) provides motor function to the cricothyroid muscle (CTM). EBSLN damage produces changes in voice quality and projection. Intraoperative neuromonitoring (IONM) in thyroid surgery aims to optimize EBSLN control during dissection. We prospectively collected the data of 88 consecutive patients who underwent total thyroidectomy with IONM from July 2019 to December 2019. IONM was offered in the intermittent mode of application. We routinely searched for the EBSLN electromyographic (EMG) signal before (S1) and after (S2) dissection of the superior vascular peduncle. In the absence of the EMG signal, we observed the CTM twitch. We identified 141 (80%) S1 EMG signals, while we recorded the CTM twitch in 15 cases (8.5%). In 20 (11.3%) cases, we were unable to identify the EMG signal. Analysing the S2 results, we found loss of EBSLN signal in 11/141 cases (7.8%) identified with IONM in pre-dissection stimulation. Among the 20 cases without pre-dissection identification (we had not identified the external branch of the superior laryngeal nerve or the muscle twitch), in the post-dissection evaluation, we confirmed the loss of signal in 17 of 20 cases, equal to 85% (p < 0.001). Our data clearly show that intraoperative stimulation and recognition of EBSLN, performed before any dissection manoeuvre to the superior vascular thyroid pole, leads to a much higher rate of nerve conservation.

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