The external laryngeal nerve in thyroid surgery: the 'no more neglected' nerve.

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dc.contributor.authorMishra, Anand Kumaren_US
dc.contributor.authorTemadari, Hemaen_US
dc.contributor.authorSingh, Nikhilen_US
dc.contributor.authorMishra, S Ken_US
dc.contributor.authorAgarwal, Amiten_US
dc.date.accessioned2007-01-02en_US
dc.date.accessioned2009-05-29T06:44:16Z
dc.date.available2007-01-02en_US
dc.date.available2009-05-29T06:44:16Z
dc.date.issued2007-01-02en_US
dc.description.abstractAIMS: To describe a novel surgical technique of 'lateralization' of superior pole to identify and save external branch of superior laryngeal nerve (EBSLN) during thyroidectomy. SETTINGS AND DESIGN: Prospective, nonrandomized at a tertiary care hospital in a specialized unit. MATERIAL AND METHODS: Over 30 months, 46 patients underwent thyroidectomy using technique of 1) 'Lateralization' of upper pole and dissection of avascular cricothyroid space 2) identification of EBSLN 3) skeletonization and individual ligation of superior thyroid vessels. Identified nerves were classified according to Cernea's classification. Outcomes were number of nerves identified, number of 'at risk' nerves' bilateral asymmetry and incidence of injury assessed by subjective interview and indirect laryngoscopy. RESULTS: Of the 78 dissected superior poles, nerves could be identified in 72 (92.31%). There were 22 (28.2%) type I, 42 (53.54%) IIa and 8 (10.25%) IIb 'at risk' nerves. In 32 patients with bilateral dissections, asymmetry of nerve was noted in 15%. Injury to nerve was not recorded in any of the patients. Average weight of glands was 69.59 g. Thyroidectomy was performed for benign disease in 28, malignancy in 4 and thyrotoxicosis in 14 patients. CONCLUSIONS: With technique of 'lateralization' and 'skeletonization and individual ligation of the superior vessels,' EBSLN identification increases and injury can be prevented. These results relate to the utilization of specific surgical technique and it is reasonable to expect that most surgeons, once familiar with the technique, should be able to achieve similar outcomes.en_US
dc.description.affiliationDepartment of Endocrine Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.en_US
dc.identifier.citationMishra AK, Temadari H, Singh N, Mishra SK, Agarwal A. The external laryngeal nerve in thyroid surgery: the 'no more neglected' nerve. Indian Journal of Medical Sciences. 2007 Jan; 61(1): 3-8en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/69149
dc.language.isoengen_US
dc.source.urihttps://www.indianjmedsci.orgen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshFeasibility Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshLaryngeal Nerves --injuriesen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRisk Assessmenten_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshThyroid Gland --surgeryen_US
dc.subject.meshThyroidectomy --methodsen_US
dc.titleThe external laryngeal nerve in thyroid surgery: the 'no more neglected' nerve.en_US
dc.typeJournal Articleen_US
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