Utility of video stylet in evaluating vocal cord mobility after thyroid and para thyroid surgery compared with direct laryngoscopy

2019 ◽  
Vol 12 (3) ◽  
pp. 307-310
Author(s):  
Khatija Y Dalvani ◽  
◽  
Jigisha P Badheka ◽  
Vrinda Oza ◽  
Jaykishan Gol ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Direct Laryngoscopy ◽  
Thyroid Surgery ◽  
Vocal Cord Mobility

scholarly journals Assessment of recurrent laryngeal nerve function during thyroid surgery

2014 ◽  
Vol 96 (2) ◽  
pp. 130-135 ◽  
Author(s):  
J Smith ◽  
J Douglas ◽  
B Smith ◽  
T Dougherty ◽  
C Ayshford
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Direct Laryngoscopy ◽  
Thyroid Surgery ◽  
Vocal Cord Palsy ◽  
Laryngeal Nerve ◽  
Laryngeal Function ◽  
Nerve Monitoring ◽  
Vocal Cord Function ◽  
Intraoperative Nerve Monitoring

Introduction There is disparity in the reported incidence of temporary and permanent recurrent laryngeal nerve (RLN) palsy following thyroidectomy. Much of the disparity is due to the method of assessing vocal cord function. We sought to identify the incidence and natural history of temporary and permanent vocal cord palsy following thyroid surgery. The authors wanted to establish whether intraoperative nerve monitoring and stimulation aids in prognosis when managing vocal cord palsy. Methods Prospective data on consecutive thyroid operations were collected. Intraoperative nerve monitoring and stimulation, using an endotracheal tube mounted device, was performed in all cases. Endoscopic examination of the larynx was performed on the first postoperative day and at three weeks. Results Data on 102 patients and 123 nerves were collated. Temporary and permanent RLN palsy rates were 6.1% and 1.7%. Most RLN palsies were identified on the first postoperative day with all recognised at the three-week review. No preoperative clinical risk factors were identified. Although dysphonia at the three-week follow-up visit was the only significant predictor of vocal cord palsy, only two-thirds of patients with cord palsies were dysphonic. Intraoperative nerve monitoring and stimulation did not predict outcome in terms of vocal cord function. Conclusions Temporary nerve palsy rates were consistent with other series where direct laryngoscopy is used to assess laryngeal function. Direct laryngoscopy is the only reliable measure of cord function, with intraoperative monitoring being neither a reliable predictor of cord function nor a predictor of eventual laryngeal function. The fact that all temporary palsies recovered within four months has implications for staged procedures.

☆Comparison of transcutaneous laryngeal ultrasound with video laryngoscope for assessing the vocal cord mobility in patients undergoing thyroid surgery

2019 ◽  
Vol 46 (4) ◽  
pp. 593-598 ◽  
Author(s):  
Manish Kumar Shah ◽  
Babita Ghai ◽  
Nidhi Bhatia ◽  
Roshan Kumar Verma ◽  
Naresh Kumar Panda
Keyword(s):  
Vocal Cord ◽  
Thyroid Surgery ◽  
Video Laryngoscope ◽  
Vocal Cord Mobility

Laryngoscopic techniques to assess vocal cord mobility following thyroid surgery

2010 ◽  
Vol 80 (11) ◽  
pp. 817-821 ◽  
Author(s):  
Pankaj Kundra ◽  
Vinoth Kumar ◽  
Krishnamachari Srinivasan ◽  
Surianarayanan Gopalakrishnan ◽  
Sudeep Krishnappa
Keyword(s):  
Vocal Cord ◽  
Thyroid Surgery ◽  
Vocal Cord Mobility

Newer Technique of Laryngeal Reinnervation: Superior Laryngeal Nerve (Motor Branch) as a Driver of the Posterior Cricoarytenoid Muscle

1989 ◽  
Vol 98 (11) ◽  
pp. 907-909 ◽  
Author(s):  
Anthony J. Maniglia ◽  
Brian Dodds ◽  
M. B. Katirji ◽  
Kelly Sorensen ◽  
Mary L. Rosenbaum
Keyword(s):  
Vocal Cord ◽  
Superior Laryngeal Nerve ◽  
Anastomosis Group ◽  
Laryngeal Nerve ◽  
Motor Branch ◽  
Vocal Cord Mobility ◽  
Nerve Anastomosis ◽  
Direct Nerve ◽  
Posterior Cricoarytenoid ◽  
The Right

This report analyzes the experience gained using two different techniques to reinnervate the paralyzed vocal cord. In the neurotization group, the superior laryngeal nerve (SLN) motor branch–cricothyroid muscle pedicle was used to reinnervate the posterior cricoarytenoid muscle. In the direct nerve anastomosis group, the SLN was anastomosed to the abductor branch of the recurrent laryngeal nerve (RLN), and the ansa hypoglossi (AH) to the adductor branch of the RLN. A third group of animals (control) had the right RLN sectioned without any anastomosis. About 5 to 6 months postoperatively the animals were killed painlessly and evaluated. The neurotization group revealed vocal fold mobilization on the right side to have an average of about half of the mobility of the left, normal side. After the RLN and SLN on the left were severed as well as the AH bilaterally, the vocal cord mobility was reduced to about one fourth. The direct nerve anastomosis group showed about fourfold less vocal cord mobility than the neurotization group. After the SLN, RLN, and AH were severed bilaterally, the control group showed no vocal cord mobility. The neurotization technique has been selected for further experimentation in human adults.

Major post-operative complications of thyroid surgery: Preventable or not?

2009 ◽  
Vol 34 (3) ◽  
pp. 99-103 ◽  
Author(s):  
M.A. Majid ◽  
Md. Ibrahim Siddique
Keyword(s):  
Total Thyroidectomy ◽  
Vocal Cord ◽  
Thyroid Surgery ◽  
Multinodular Goiter ◽  
Vocal Cord Palsy ◽  
Subtotal Thyroidectomy ◽  
Permanent Hypoparathyroidism ◽  
Respiratory Obstruction ◽  
Operative Complications ◽  
Toxic Multinodular Goiter

Factors responsible for major complications following thyroid surgery in 598 patients were studied. Patients with non toxic multinodular goiter involving both lobes of thyroid constituted the maximum bulk subjected to thyroidectomy. The most frequent procedure was bilateral subtotal thyroidectomy. Reactionary hemorrhage occurred in 6 patients, all following bilateral procedures and among them 5 patients developed tension hematoma with respiratory obstruction despite the presence of a drain. Temporary vocal cord palsy was observed in 7 patients whereas one patient subjected to total thyroidectomy with neck dissection for papillary carcinoma of thyroid developed permanent right vocal cord palsy. Temporary parathyroid insufficiency was seen in 51 patients and one patient developed permanent hypoparathyroidism. Incidence of parathyroid insufficiency was higher in bilateral procedures as compared to unilateral ones. There was no operation related death in this series, but complications like hemorrhage, vocal cord palsy and parathyroid insufficiency following thyroid surgery are still a deep concern. Keywords: Complication; Post-operative; Thyroid surgeryOnline: 29-1-2009DOI: 10.3329/bmrcb.v34i3.1973     Bangladesh Med Res Counc Bull 2008; 34: 99-103. 

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