Purpose of the study: Aimed to highlight a rare anatomical variation of right recurrent laryngeal nerve and a brief review of literature.Nonrecurrent laryngeal nerve is a rare anatomical variation with an incidence of 0.5 to 0.7% in thyroid surgery. It is difficult to identify this variation preoperatively either by imaging or by signs and symptoms, unless a vascular anomaly is suspected.This study aims to underline the necessity of recognizing the possibility of non-RLN and also to follow a systematic dissection of recurrent laryngeal nerve during thyroid surgeries, to prevent intraoperative nerve damage.
Aims To assess preoperative and postoperative shoulder function by electromyography (EMG) in spinal accessory nerve (SAN) sparing neck dissections in head and neck cancers. Materials and methods A prospective study was done on 50 patients (51 shoulders) with histopathologically proven head and neck cancers with N0 or N1 neck who underwent nerve sparing neck dissections. Patients were assessed preoperatively and postoperatively at 3 weeks and 3 months by needle EMG and muscle strength tests of upper trapezius. Results and interpretation: At 3 weeks postoperatively, 11 shoulders (39.3%) in FND group and four shoulders (33.3%) in modified radical neck dissection (MRND) group showed severely abnormal EMG, while in supraomohyoid neck dissection (SOHND) group only two (18.2%) shoulders showed severely abnormal EMG. All patients who underwent nerve sparing neck dissections showed improvement in at least one category on the second electromyogram at 3 months. This could be attributed to neuropraxia or transient devascularization of the accessory nerve. In our study, 11 patients in FND group showed severely abnormal EMG finding, but they did not have as great a degree of shoulder dysfunction as would be expected. This could be due to factors like preoperative condition of other synergistic shoulder girdle muscles, postoperative exercises, etc. Conclusion SAN injuries are common in all types of nerve sparing neck dissections requiring aggressive physiotherapy for an improved shoulder function. To conclude, in patients in whom it is oncologically sound, nerve sparing neck dissections offers significant benefit in terms of shoulder function. How to cite this article Mohiyuddin A, Raj S, Merchant S, Oomen, Kottaram PJ. Electromyographic Assessment of Accessory Nerve Function Following Nerve Sparing Neck Dissection. Int J Head and Neck Surg 2013;4(1):19-23.
Thyroidea ima is a rare anomalous artery supplying the thyroid gland apart from the superior and inferior thyroid arteries. It is of surgical importance in thyroid, parathyroid and tracheal surgeries.Our study aims to highlight two cases of thyroidea ima artery found during thyroidectomy:• Case 1: Thyroidea ima artery was seen arising from the medial surface of the right common carotid artery in a female patient, who underwent total thyroidectomy. • Case 2: Thyroidea ima artery was seen arising from the anterior surface of the right innominate artery, in a female patient, who underwent right hemithyroidectomy.Conclusion: Thyroidea ima artery, although a rare arterial variation, a thorough regional anatomic knowledge and meticulous dissection will not only help us in identifying such a vascular variation, also help us in preventing an accidental injury.
Introduction:To propose an operation similar to selective neck dissection (levels II, III and IV) as a method of successful management of second arch branchial anomalies.
Aims To describe an unusual presentation of myxoid liposarcoma of oropharynx and a brief review of literature. Introduction Liposarcomas of head and neck are very rare. Its treatment and prognosis mainly depends on the site and the histologic pattern of the tumor. Case presentation The present case report describes a 65-year-old male with complaints of dysphagia, dyspnea, and a peculiar complaint of mass in the throat which turned out to be a low-grade myxoid liposarcoma arising from right lateral wall of oropharynx extending intraluminal in the esophagus, compressing posterior wall of trachea. The mass was successfully excised surgically and postoperative period was uneventful and patient was asymptomatic 4 months after surgery. Conclusion Myxoid liposarcoma is a rare tumor in head and neck and surgical excision with adequate margin is the treatment of choice. How to cite this article Mohiyuddin A, Raj S, Merchant S, Arun P. Interesting Clinical Presentation of Myxoid Liposarcoma of Oropharynx. Int J Head and Neck Surg 2013;4(1):57-58.
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