Phonatory function in patients with well-differentiated thyroid carcinoma following meticulous resection of tumors adhering to the recurrent laryngeal nerve

Miyamaru, Satoru; Kumai, Yoshihiko; Murakami, Daizo; Kodama, Narihiro; Miyamoto, Takumi; Yumoto, Eiji; Orita, Yorihisa

doi:10.1007/s10147-019-01496-w

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…Consequently, about 83% patients restored nearly normal phonatory function. Other studies also demonstrated non-significant differences between shaving technique and nerve resection in PTC patients' RFS and disease specific survival, while shaving technique preserved better RLN function (13,32,46). As for postoperative hypoparathyroidism, non-statistical significances were detected between those with or without RLN invasion, suggested that standardized procedures and abundant experience are the keys to preserve intact parathyroid function when dealing with RLN involvement during the surgery.…”

Section: Discussionmentioning

confidence: 98%

Predictive factors and risk analysis of recurrent laryngeal nerve invasion in papillary thyroid carcinoma ≤ 1 cm

Yang¹,

Wang²,

Rao³

et al. 2023

Archives of Endocrinology and Metabolism

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Objective:The recurrent laryngeal nerve (RLN) may be involved by papillary thyroid carcinoma ≤ 1 centimeter (PTC ≤ 1 cm). Current study investigated the predictive factors of RLN invasion in PTC ≤ 1 cm, the risk factors of disease recurrence in RLN invaded cases and the results of surgical management for RLN invasion. Materials and methods: Data of 374 PTC ≤ 1 cm patients were retrospectively collected. We performed univariate and multivariate analysis to identify predictive factors of RLN invasion and risk factors of disease recurrence. The abilities of factors in predicting RLN invasion were evaluated. Surgical outcomes and recurrence free survival (RFS) of patients were analyzed. Results: A total of 28 patients suffered RLN invasion, among which seven had disease recurrence. Preoperative vocal cord palsy (VCP), gross extrathyroidal extension, larger tumor size and tumor on the dorsal side of thyroid were verified as predictive factors of RLN invasion. RLN involved patients had poorer RFS, but better than those who also had upper-aerodigestive tract invasion. Upper-aerodigestive tract invasion, lateral neck lymph nodes metastasis (LNM) and BRAF V600E mutation were independent risk factors of disease recurrence in RLN invaded cases. Tumor shaving showed better RLN function preservation without increasing recurrent risk. Conclusions: Current study confirmed the rarity of RLN invasion in PTC ≤ 1 cm. Various aggressive features were verified as predictive factors of RLN invasion. Tumor shaving showed superiority in preserving nerve function without increasing recurrent risk. Special attentions should be paid for disease recurrence when RLN invasion accompanied by upper-aerodigestive tract invasion, lateral neck LNM or BRAF V600E mutation.

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Section: Discussionmentioning

confidence: 98%

Predictive factors and risk analysis of recurrent laryngeal nerve invasion in papillary thyroid carcinoma ≤ 1 cm

Yang¹,

Wang²,

Rao³

et al. 2023

Archives of Endocrinology and Metabolism

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“…The vocal outcomes after the shaving technique in this study showed excellent results, that is, aerodynamic parameters were in the normal range and acoustic and perceptual parameters reached near-normal levels. The advantages of the shaving technique include not only good vocal function, but also a high frequency of preservation of VF mobility with excellent oncological safety [ 4 , 5 , 6 , 7 , 8 ]. The restoration of VF mobility after the shaving technique has been reported to range between 60–92% [ 4 , 6 , 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…RLN paralysis (RLNP) can cause persistent breathy hoarseness, shortening of phonation, and aspiration, which adversely affects patient quality of life [ 2 , 3 ]. Therefore, in thyroid cancer patients with preoperatively functional vocal folds (VF), first, sharp tumor resection from the RLN should be considered to maintain good voice and VF mobility with oncological safety [ 4 , 5 , 6 , 7 , 8 ]. When it is difficult to preserve the RLN during complete removal of the thyroid cancer, it is desirable to adopt the RLN reconstruction procedure simultaneously during thyroid surgeries [ 9 , 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Optimal Management of the Unilateral Recurrent Laryngeal Nerve Involvement in Patients with Thyroid Cancer

Miyamaru

Murakami

Nishimoto

et al. 2021

Cancers

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We aimed to determine the optimal management of recurrent laryngeal nerve (RLN) involvement in thyroid cancer. We enrolled 80 patients with unilateral RLN involvement in thyroid cancer between 2000 and 2016. Eleven patients with preoperatively functional vocal folds (VFs) underwent sharp tumor resection to preserve the RLN (shaving group). Thirty-three patients underwent RLN reconstruction with RLN resection (reconstruction group). We divided the reconstruction group into two subgroups based on preoperative VF mobility (normal-reconstruction and paralyzed-reconstruction subgroups). In the cases where RLN reconstruction was difficult, phonosurgeries including arytenoid adduction (AA), with or without thyroplasty type I, or nerve muscle pedicle implantation with AA were performed later (phonosurgery group). We evaluated and compared vocal function among the evaluated periods and different groups. Postoperative vocal function in the shaving and normal-reconstruction subgroups was favorable. There were no significant differences between the two groups. In the paralyzed-reconstruction and phonosurgery groups, postoperative vocal function was significantly improved, and vocal function in the paralyzed-reconstruction subgroup was significantly better than that in the phonosurgery group. For optimal management of unilateral RLN involvement in thyroid cancer, first, sharp dissection should be performed, and if this is impossible, a simultaneous RLN reconstruction procedure should be adopted whenever possible.

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“…Propylene glycol gel PRG is a synthetic vocal tract. Methods and technologies for rejuvenation of the human voice restoring the lexibility that the vocal cord loses with disease or age are emerging as a result of the collaboration between scientists and physicians (Miyamaru et al, 2019).…”

Section: Future Possibilitiesmentioning

confidence: 99%

Synthetic Vocal Tracts - A Review

P¹,

K²

2020

ijrps

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Synthetic vocal tracts are gadgets powered by a computer system capable of translating the brain activity into synthesized speech, by decoding the movements of muscles involved in vocalization, using advanced computer programming. New standardized method for the development of synthetic vocal tract is the 3D vocal tract model with the binary conversion. Few of the typical features considered while creating the synthetic vocal tract are fundamental frequency, perturbation measure, jitter and change in pitch. The tissue engineered larynx is the promising development in synthetic vocal tract treatment in case of patients with vocal fold repair and regeneration. The future of this interesting technology lies in using high speed video endoscopy based synthetic vocal cords. The review was done based on the articles obtained from various platforms. This review article elaborates about the principle of synthetic vocal tract. Quality of the article used was assessed using a quality assessment tool and graded as strong, moderate and weak. The aim of this study is to understand the concept of synthetic vocal tract and its significance. Synthetic vocal tract is a recently established biomedical tool that has come as a boon in treating patients with severe disabilities. Speech synthesis is evolving as a viable solution as more research is being carried out on this. To understand the full significance of this crucial technique, more research has to be carried out on this field of biomedical engineering and viable solutions need to be developed, so that this novel technique is fully utilized.

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Phonatory function in patients with well-differentiated thyroid carcinoma following meticulous resection of tumors adhering to the recurrent laryngeal nerve

Cited by 6 publications

References 18 publications

Predictive factors and risk analysis of recurrent laryngeal nerve invasion in papillary thyroid carcinoma ≤ 1 cm

Predictive factors and risk analysis of recurrent laryngeal nerve invasion in papillary thyroid carcinoma ≤ 1 cm

Optimal Management of the Unilateral Recurrent Laryngeal Nerve Involvement in Patients with Thyroid Cancer

Synthetic Vocal Tracts - A Review

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