Computer-assisted evoked electromyography with stimulating surgical instruments for recurrent/external laryngeal nerve identification and preservation in thyroid and parathyroid operation

Surgery ◽  
2002 ◽  
Vol 132 (6) ◽  
pp. 1100-1108 ◽  
Author(s):  
Alan P.B. Dackiw ◽  
Lorne E. Rotstein ◽  
Orlo H. Clark
Keyword(s):  
Laryngeal Nerve ◽  
Surgical Instruments ◽  
Computer Assisted ◽  
External Laryngeal Nerve ◽  
Evoked Electromyography ◽  
Nerve Identification

Identification and preservation of External Branch of the Superior Laryngeal Nerve during thyroid surgeries at NMCTH

2017 ◽  
Vol 13 (3) ◽  
pp. 306-310 ◽  
Author(s):  
Rupesh Raj Joshi ◽  
Anupama Shah Rijal ◽  
Kundhan Kumar Shrestha ◽  
Anup Dhungana ◽  
Shova Maharjan
Keyword(s):  
Case Series ◽  
Superior Laryngeal Nerve ◽  
Thyroid Neoplasms ◽  
Laryngeal Nerve ◽  
Type I ◽  
Tertiary Centre ◽  
External Branch ◽  
Common Diagnosis ◽  
Recurrent Laryngeal Nerves ◽  
Nerve Identification

Background & Objectives:The most common reason for thyroid surgery is the presence of benign or malignant nodules. Subjective voice disturbance after thyroidectomy is very common, even without injury to the recurrent laryngeal nerves. One possible cause for postoperative dysphonia is injury to the External branch of superior laryngeal nerve (EBSLN). Cernea classification, which we followed in this study, is one of the most popular worldwide classifications of the EBSLN. The study was conducted with objectives to identify and classify EBSLN according to Cernia classification in Nepalese population and help surgeons understand the anatomy of the EBSLN and to preserve the nerve during thyroidectomy. Materials & Methods:A prospective observational case series of seventy-nine patients, who were diagnosed with thyroid neoplasms and underwent thyroid surgeries at the tertiary centre of Kathmandu between 1st January 2015 to 31st December 2016. All procedures were performed by transverse collar incision. We classified the anatomy of the EBSLN using Cernea classification.  Results:There were total of 79 patients. Most common diagnosis and surgery were colloid goitre and hemithyroidectomies respectively. A total of 94 EBSLNs were evaluated.  Cernia Type I was observed in 27.66%, type IIa in 46.80%, and type IIb in 14.89%. Incidences of types IIa and IIb, which put patients at greater risk for intra-operative injury, were observed in 61.69% in our study. The nerve could not be identified in 10.64%. Conclusion:It is possible to increase the rate of nerve identification and avoid the nerve injury even in the absence of sophisticated equipment.

scholarly journals Origin of superior thyroid artery: under the surgeon’s knife

2018 ◽  
Vol 17 (4) ◽  
pp. 290-295 ◽  
Author(s):  
Ranjith Sreedharan ◽  
Lalu Krishna ◽  
Ashwija Shetty
Keyword(s):  
Thyroid Gland ◽  
Carotid Artery ◽  
Head And Neck ◽  
Single Case ◽  
External Carotid Artery ◽  
Laryngeal Nerve ◽  
External Carotid ◽  
Superior Thyroid Artery ◽  
External Laryngeal Nerve ◽  
The Common

Abstract Background The major arterial supply to the thyroid gland is from the superior and inferior thyroid arteries, arising from the external carotid artery and the thyrocervical trunk respectively. The external laryngeal nerve runs in close proximity to the origin of the superior thyroid artery in relation to the thyroid gland. The superior thyroid artery is clinically important in head and neck surgeries. Objectives To locate the origin of the superior thyroid artery, because wide variability is reported. To provide knowledge of possible variations in its origin, because it is important for surgical procedures in the neck. Methods The origin of the superior thyroid artery was studied by dissecting sixty adult human hemineck specimens from donated cadavers in a Department of Anatomy. Results The highest incidence observed was origin of the superior thyroid artery from the external carotid artery (88.33%), whereas origin from the common carotid bifurcation only occurred in 8.33%. However, in 3.33% of cases, the superior thyroid artery originated from the common carotid artery and in a single case, the external laryngeal nerve did not cross the stem of the superior thyroid artery at all, but ran ventral and parallel to the artery. Conclusions It is important to rule out anomalous origin of superior thyroid artery and verify its relationship to the external laryngeal nerve prior to ligation of the artery in thyroid surgeries, in order to prevent iatrogenic injuries. Moreover, because anomalous origins of the superior thyroid artery are only anatomic variants, thorough knowledge of these is decisive for head and neck surgeries.

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