scholarly journals Complications of Transoral Thyroidectomy: Overview and Update

2020 ◽  
Author(s):  
Kyung Tae
Keyword(s):  
Nerve Injury ◽  
Jugular Vein ◽  
Transoral Approach ◽  
Mental Nerve ◽  
Safety Zone ◽  
Transoral Thyroidectomy ◽  
Surgical Morbidity ◽  
Transcervical Approach ◽  
Vestibular Approach ◽  
Neural Monitoring

Transoral thyroidectomy via the vestibular approach has become popular worldwide. It offers the following advantages: less surgical morbidity, excellent postoperative cosmesis, and superior functional voice outcomes. Several studies have reported surgical outcomes of the transoral approach as comparable to those of the conventional transcervical approach in selected patients. However, unusual complications, such as CO2 embolism, mental nerve injury, surgical space infection, skin perforation, burns, and trauma have been noted in transoral thyroidectomy. This paper aims to review and update these complications and their management. Routine intraoperative neural monitoring is required to avoid laryngeal nerve palsy in the transoral approach. To prevent CO2 embolism, surgeons need to be careful not to injure the anterior jugular vein, and the CO2 insufflation pressure should be set as low as 4–6 mmHg. To avoid mental nerve injury, vestibular incisions should be placed in the safety zone, and dissection of the vestibular area and chin should be minimized. In conclusion, recognizing the possibility of complications and understanding their prevention and management are important for patient safety and the success of the transoral approach.

Sensory change in the chin and neck after transoral thyroidectomy: Prospective study of mental nerve injury

Head & Neck ◽  
2020 ◽  
Vol 42 (11) ◽  
pp. 3111-3117
Author(s):  
Kyung Tae ◽  
Dong Won Lee ◽  
Hyang Sook Bang ◽  
You Hern Ahn ◽  
Jung Hwan Park ◽  
...  
Keyword(s):  
Prospective Study ◽  
Nerve Injury ◽  
Mental Nerve ◽  
Transoral Thyroidectomy ◽  
Sensory Change

scholarly journals Transoral Endoscopic Thyroidectomy via Vestibular Approach With 4 Trocars: A New Technique

2020 ◽  
pp. 014556132094335
Author(s):  
Duy Quoc Ngo ◽  
Toan Duc Tran ◽  
Quy Xuan Ngo ◽  
Quang Van Le
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Endoscopic Thyroidectomy ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Mental Nerve ◽  
Feasible Method ◽  
Laryngeal Nerve Injury ◽  
A New Technique ◽  
Vestibular Approach

Objectives: The objective of this study was to report the feasibility and safety of a novel 4-trocar approach for transoral endoscopic thyroidectomy via the vestibular. Methods: In this study, we first used 4 trocars via vestibular area to perform transoral endoscopic thyroidectomy. We reported the safety and surgical feasibility of transoral endoscopic thyroidectomy using a 4-trocar technique in our institute from February 1, 2020, to May 10, 2020. Results: Transoral endoscopic thyroidectomy via the vestibular approach using 4 trocars was carried out in 5 patients. No complications such as bleeding, mental nerve injury, recurrent laryngeal nerve injury, or hypoparathyroidism were reported. All patients were completely satisfied with the cosmetic results. Conclusions: Transoral endoscopic thyroidectomy with 4 trocars via vestibular approach is an effective and feasible method. Markedly, this technique can assist surgeons to expose and preserve both parathyroid glands and recurrent laryngeal nerve easily when performing transoral endoscopic thyroidectomy.

Phrenic Nerve Injury Associated with Venipuncture of the Internal Jugular Vein

CHEST Journal ◽  
1980 ◽  
Vol 78 (5) ◽  
pp. 777-779 ◽  
Author(s):  
James V. Vest ◽  
MaryBeth Pereira ◽  
Robert M. Senior
Keyword(s):  
Nerve Injury ◽  
Internal Jugular Vein ◽  
Phrenic Nerve ◽  
Jugular Vein ◽  
Phrenic Nerve Injury

scholarly journals Does nerve injury following minimally invasive calcaneal osteotomy clinically correlate to Talusan’s Zone?

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0048
Author(s):  
Kar Teoh ◽  
Kartik Hariharan
Keyword(s):  
Minimally Invasive ◽  
Nerve Injury ◽  
Sural Nerve ◽  
Safe Zone ◽  
Lateral Side ◽  
Surgical Morbidity ◽  
Closing Wedge ◽  
Calcaneal Osteotomy ◽  
Alternative Method ◽  
Calcaneal Tuberosity

Category: Hindfoot Introduction/Purpose: Talusan et al (FAI, 2005) described a safe zone for neural structures in medial displacement calcaneal osteotomy following a cadaveric and radiographic investigation. The safe zone was determined to be within the area 11.2 ± 2.7 mm anterior to the landmark line which is from the plantar fascia origin through the center of the posterosuperior aspect of the calcaneal tuberosity. Minimally invasive calcaneal osteotomies been gaining in popularity as it minimises soft tissue disruption and surgical morbidity. However, neural structures are at risk on both the medial and lateral side of the foot during this procedure. We aim to correlate our clinical results with Talusan’s Radiographic Zone (TRZ) following minimally invasive calcaneal osteotomies. Methods: Sixty-three calcaneal osteotomies were performed in our unit from 2010 and 2016. The type of osteotomies was as follows: Medialising, n = 34; Lateralising n =15; Zadek (Dorsal closing wedge), n =13; and Dwyer (lateral closing wedge), n = 1. Clinical data were recorded with any nerve injury noted. The calcaneal osteotomies were graded into whether they fell into TRZ. We also evaluated Talusan’s alternative method which he described and is based on alternative line 60% of the distance from the angle of Gissane to the tip of most posterior aspect of the calcaneal tuberosity where the safe zone is a window 5.6 mm anterior to this. Results: Five (8%) patients (Medialising, n = 2; Lateralising n =2; Zadek, n =1) reported sural nerve paraesthesia following surgery in our series. However, this was transient and they recovered fully. In total, seven patients (Medialising, n = 4; Lateralising n =1; Zadek, n =1; Dwyer, n=1) fell outside TRZ in our series, of which 2 reported transient sural nerve paraesthesia. Based on our results, TRZ clinically correlated with nerve injury (Chi square test, p=0.032). The other three patients who reported sural nerve paraesthesia but fell inside TRZ measured on average 10.4 mm from the landmark line (10.2, 10.4, 10.7 mm). However when we used the alternative method, they all fell outside the safe zone of this alternative line. Conclusion: Our results suggest that TRZ clinically correlated with nerve injury. However, the alternative line (where the safe zone is a window 5.6 mm anterior to this line) might be more accurate than the landmark line (where the safe zone is 11.2 ± 2.7 mm anterior to this line). More clinical studies with larger numbers might be required to confirm this.

Isolated phrenic nerve injury after apparently atraumatic puncture of the internal jugular vein

1989 ◽  
Vol 15 (2) ◽  
pp. 132-134 ◽  
Author(s):  
B. Depierraz ◽  
A. Essinger ◽  
D. Morin ◽  
J. -J. Goy ◽  
E. Buchser
Keyword(s):  
Nerve Injury ◽  
Internal Jugular Vein ◽  
Phrenic Nerve ◽  
Jugular Vein ◽  
Phrenic Nerve Injury

scholarly journals The intuitive da Vinci single port surgical system and feasibility of transoral thyroidectomy vestibular approach

2020 ◽  
Vol 5 ◽  
pp. 20-20
Author(s):  
Mohammad Shaear ◽  
Jonathon O. Russell ◽  
Samuel Steck ◽  
Rui Han Liu ◽  
Lena W. Chen ◽  
...  
Keyword(s):  
Da Vinci ◽  
Single Port ◽  
Transoral Thyroidectomy ◽  
Vestibular Approach ◽  
Surgical System

scholarly journals Endoscopic resection of the submandibular gland: a new surgical approach

2016 ◽  
Vol 18 (3) ◽  
pp. 18
Author(s):  
Sumeet Karn ◽  
Archit Pandit
Keyword(s):  
Submandibular Gland ◽  
Nerve Injury ◽  
Endoscopic Resection ◽  
Surgical Approach ◽  
Gland Tumor ◽  
Surgical Trials ◽  
Transcervical Approach ◽  
Acute Complications ◽  
Endoscopic Assistance ◽  
Submandibular Gland Excision

Introduction: Submandibular gland excision is traditionally performed by the transcervical approach. To avoid or reduce visible scarring and nerve injury, diverse innovative surgical trials have been reported. Here we report a patient who had an endoscopic submandibular gland resection via a hairline incision.Methods: A 36-year-old woman presented with a right submandibular gland tumor that was found on a routine check-up. The submandibular gland was resected under endoscopic assistance via a posterior hairline incision using an ultrasonic scalpel.Results: The resection was successful, causing no acute complications, such as neural injury, hematoma, or seroma formation. The incision scar healed with an excellent cosmetic result.Conclusions: Endoscopic submandibular gland resection via a hairline incision was feasible and resulted in an excellent surgical and cosmetic outcome.

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