Injuries to the Recurrent Laryngeal Nerve in Thyroid Operations

Lahey, Frank H.; Hoover, Walter B.

doi:10.1097/00000658-193810000-00006

Cited by 157 publications

(102 citation statements)

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“…Surgeons argued in the past that exploration of the nerve would increase the risk of injury. That if you remained capsular you wouldn't stray into the course of the nerve (7,8). Perhaps this was driven by the held believe that once injured, the recurrent laryngeal nerve could not be repaired (7).…”

Section: Routine Intra-operative Nerve Explorationmentioning

confidence: 99%

“…That if you remained capsular you wouldn't stray into the course of the nerve (7,8). Perhaps this was driven by the held believe that once injured, the recurrent laryngeal nerve could not be repaired (7). This changed in the late 1930s driven by the studies by Lahey of Boston and Ridell of London (7,8).…”

Section: Routine Intra-operative Nerve Explorationmentioning

confidence: 99%

“…Perhaps this was driven by the held believe that once injured, the recurrent laryngeal nerve could not be repaired (7). This changed in the late 1930s driven by the studies by Lahey of Boston and Ridell of London (7,8). Between 1935 and 1938, Lahey started exploring the nerves and exposing them during thyroid surgery.…”

Section: Routine Intra-operative Nerve Explorationmentioning

confidence: 99%

“…Between 1935 and 1938, Lahey started exploring the nerves and exposing them during thyroid surgery. At this time, the prevailing international rates of nerve injury stood at 3% while in Lahey's clinic the nerve injury rates were 1.5% (7). He operated on 3000 nerves at risk and followed up the patients documenting any nerve injuries.…”

Section: Routine Intra-operative Nerve Explorationmentioning

confidence: 99%

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The Recurrent Laryngeal Nerve and Thyroid Surgery; Who to Scope, When to Visualize, Who to Stimulate

Mwenda¹

2016

Ann Afr Surg.

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OPINION SummaryThyroid surgery is a common general and specialist surgical procedure. Recurrent laryngeal nerve injury during thyroid surgery, though rare, is the most feared surgical complication. Various steps and perioperative assessments can minimize recurrent laryngeal nerve injury. In this opinion article, two clinical vignettes are used at the introduction to discuss this topic. Literature is reviewed and conclusions made in the aspects of intra-operative recurrent laryngeal nerve exposure, the utility of intra-operative nerve monitoring and the use of peri-operative laryngoscopy where indicated. In conclusion, the literature shows that nerve exposure during thyroidectomy is a must. Nerve monitoring does not reduce the incidence of recurrent laryngeal nerve injury. All patients with pre-operative voice changes, cancer, prior head and neck surgery and those due for re-do thyroidectomy require pre-operative laryngocsopy.

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Section: Routine Intra-operative Nerve Explorationmentioning

confidence: 99%

Section: Routine Intra-operative Nerve Explorationmentioning

confidence: 99%

Section: Routine Intra-operative Nerve Explorationmentioning

confidence: 99%

Section: Routine Intra-operative Nerve Explorationmentioning

confidence: 99%

See 2 more Smart Citations

The Recurrent Laryngeal Nerve and Thyroid Surgery; Who to Scope, When to Visualize, Who to Stimulate

Mwenda¹

2016

Ann Afr Surg.

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“…The rate of RLN injury in reoperation, rate of recovery after loss of signal and utility value in reoperation with complication did not have any effect on the analysis (figure 2). The tornado analysis showed that most important variables were RLN injury frequency in the control arm, utility of reoperation (12). Many reports have suggested that intraoperative neuromonitoring could further decrease the risk of RLN injury during thyroid surgery (7,(13)(14)(15)(16).…”

Section: Utility Analysismentioning

confidence: 99%

Análisis económico de la neuromonitoría rutinaria del nervio laríngeo recurrente en tiroidectomía total

Sanábria

Ramírez

2015

biomedica

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Introduction: Thyroidectomy is a common surgery. Routine searching of the recurrent laryngeal nerve is the most important strategy to avoid palsy. Neuromonitoring has been recommended to decrease recurrent laryngeal nerve palsy. Objective: To assess if neuromonitoring of recurrent laryngeal nerve during thyroidectomy is costeffective in a developing country. Materials and methods:We designed a decision analysis to assess the cost-effectiveness of recurrent laryngeal nerve neuromonitoring. For probabilities, we used data from a meta-analysis. Utility was measured using preference values. We considered direct costs. We conducted a deterministic and a probabilistic analysis. Results: We did not find differences in utility between arms. The frequency of recurrent laryngeal nerve injury was 1% in the neuromonitor group and 1.6% for the standard group. Thyroidectomy without monitoring was the less expensive alternative. The incremental cost-effectiveness ratio was COP$ 9,112,065. Conclusion: Routine neuromonitoring in total thyroidectomy with low risk of recurrent laryngeal nerve injury is neither cost-useful nor cost-effective in the Colombian health system.

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Recurrent Laryngeal Nerve

Cernea

Hojaij²,

Carlucci³

et al. 2009

Arch Otolaryngol Head Neck Surg

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Extralaryngeal branching was found in 64.53% of RLNs in this case series. In recent patients with intraoperative laryngeal nerve monitoring, electrophysiologic activity was observed in the branches, particularly the anteriorly situated ones. Recognition of this frequent anatomical configuration and meticulous preservation of all branches are of paramount importance to decrease postoperative morbidity associated with thyroidectomy.

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Injuries to the Recurrent Laryngeal Nerve in Thyroid Operations

Cited by 157 publications

References 0 publications

The Recurrent Laryngeal Nerve and Thyroid Surgery; Who to Scope, When to Visualize, Who to Stimulate

The Recurrent Laryngeal Nerve and Thyroid Surgery; Who to Scope, When to Visualize, Who to Stimulate

Análisis económico de la neuromonitoría rutinaria del nervio laríngeo recurrente en tiroidectomía total

Recurrent Laryngeal Nerve

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