In Response to Letter to the Editor Regarding: Is Cricothyroid Muscle Twitch Predictive of the Integrity of the EBSLN in Thyroid Surgery?

2019 ◽  
Author(s):  
Eui‐Suk Sung ◽  
Jae Hyeok Chang ◽  
Jia Kim ◽  
Wonjae Cha
Keyword(s):  
Thyroid Surgery ◽  
Muscle Twitch ◽  
Cricothyroid Muscle ◽  
Letter To The Editor

Is cricothyroid muscle twitch predictive of the integrity of the EBSLN in Thyroid Surgery?

2018 ◽  
Vol 128 (11) ◽  
pp. 2654-2661 ◽  
Author(s):  
Eui-Suk Sung ◽  
Jae Hyeok Chang ◽  
Jia Kim ◽  
Wonjae Cha
Keyword(s):  
Thyroid Surgery ◽  
Muscle Twitch ◽  
Cricothyroid Muscle

Regarding: Cricothyroid muscle twitch could be a preventive tool for EBSLN injury in thyroid surgery

2019 ◽  
Author(s):  
Tzu‐Yen Huang ◽  
Wing‐Hei Viola Yu ◽  
Feng‐Yu Chiang ◽  
Che‐Wei Wu
Keyword(s):  
Thyroid Surgery ◽  
Muscle Twitch ◽  
Cricothyroid Muscle

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.

External Branch of the Superior Laryngeal Nerve: Applied Surgical Anatomy and Implications in Thyroid Surgery

2012 ◽  
Vol 78 (9) ◽  
pp. 986-991 ◽  
Author(s):  
George H. Sakorafas ◽  
Panayiotis Kokoropoulos ◽  
Christos Lappas ◽  
Dimitrios Sampanis ◽  
Vassilios Smyrniotis
Keyword(s):  
Thyroid Surgery ◽  
Full Range ◽  
Superior Laryngeal Nerve ◽  
Surgical Anatomy ◽  
Laryngeal Nerve ◽  
Injury Incidence ◽  
High Frequencies ◽  
Cricothyroid Muscle ◽  
External Branch ◽  
Operating Surgeon

The external branch of the superior laryngeal nerve (EBSLN) is the only motor supply to the cricothyroid muscle and has an important role during phonation in high frequencies. Iatrogenic injury of the EBSLN, most commonly during thyroid surgery, is associated with varying levels of alterations in phonation, which may have an impact on a patient's life, especially when his or her career depends on the full range of voice. EBSLN injury incidence after thyroid surgery ranges widely in the literature (0 to 58%). Despite this wide variation, it appears that EBSLN injury is a not uncommon, and frequently overlooked, complication of thyroid surgery. An in-depth knowledge of the surgical anatomy of the EBSLN is therefore required from the part of the operating surgeon to protect this nerve during thyroid surgery.

Letter to the Editor

1978 ◽  
Vol 9 (3) ◽  
pp. 197-200
Author(s):  
Peter B. Smith
Keyword(s):  
Letter To The Editor
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