Recurrent Laryngeal Nerve Injury After Thyroid Surgery: An Analysis of 11,370 Patients

Gunn, Alexander; Oyekunle, Taofik; Stang, Michael T.; Kazaure, Hadiza S.; Scheri, Randall P.

doi:10.1016/j.jss.2020.05.017

Cited by 50 publications

(38 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sudden nerve injuries, such as those resulting from transection, clamping, ligation, or cautery, are less likely to result in graded partial EMG changes and generally occur too quickly to be prevented by any form of IONM. However, in the case of clamping and ligation injuries, C‐IONM may aid in mitigating their severity by enabling early recognition and release of the distressed nerve 38,51,72–74 …”

Section: Resultsmentioning

confidence: 99%

Clarifying optimal outcome measures in intermittent and continuous laryngeal neuromonitoring

et al. 2021

View full text Add to dashboard Cite

Background Intraoperative neuromonitoring (IONM) techniques have evolved over the past decade into intermittent IONM (I‐IONM) and continuous IONM (C‐IONM) modes of application. Despite many prior publications on both types of IONM, there remains uncertainty about what outcomes should be measured for each form of IONM. The primary objective of this paper is to define categories of benefit for I‐IONM/C‐IONM and to clarify and standardize their reporting outcomes. Methods Expert review consensus statement utilizing modified Delphi methodology. Results I‐IONM provides diagnosis, classification, and prevention of nerve injury through accurate and early nerve identification. C‐IONM provides real‐time information on nerve functional integrity and thus may prevent some types of nerve injury but cannot assist in nerve localization. Sudden mechanisms of nerve injury cannot be predicted or prevented by either technique. Conclusions I‐IONM and C‐IONM are complementary techniques. Future studies evaluating the utility of IONM should focus on outcomes that are appropriate to the type of IONM being utilized.

show abstract

Section: Resultsmentioning

confidence: 99%

Clarifying optimal outcome measures in intermittent and continuous laryngeal neuromonitoring

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Although thyroidectomy is now considered a very safe surgery, known complications can seriously compromise patients’ quality of life [ 16 ]. Postoperative hemorrhage [ 17 , 18 ], recurrent laryngeal nerve injury (RLN) [ 19 ] and hypocalcemia [ 20 , 21 ] represent the most common adverse events after thyroidectomy. In this study, we focus on the risk of postoperative hypocalcemia.…”

Section: Discussionmentioning

confidence: 99%

PTH after Thyroidectomy as a Predictor of Post-Operative Hypocalcemia

Metere¹,

Biancucci

Natili³

et al. 2021

Diagnostics

View full text Add to dashboard Cite

Post-thyroidectomy hypocalcemia is a frequent complication with significant morbidity, and has been shown to increase hospital stay and readmission rates. The evaluation of serum parathyroid hormone (PTH) levels after thyroidectomy represents a reliable method to predict post-thyroidectomy hypocalcemia, but it remains infrequently used. This retrospective study investigates serum PTH values 3 h after thyroidectomy as a predictor of hypocalcemia. In this study, we enrolled 141 patients aged between 27 and 71 years eligible for total thyroidectomy who presented with multinodular goiter, suspicious nodule on cytological examination, Graves’ disease, or toxic multinodular goiter. Three hours after total thyroidectomy, 53 patients (37.6%) showed a reduction in serum PTH. Of these patients 75.5% developed hypocalcemia by 24 h after surgery and 100% were hypocalcemic after 48 h (p < 0.001). There was no significant difference attributable to the different thyroid diseases, nor to the age of the patients. PTH at 3 h after total thyroidectomy accurately predicts post-operative hypocalcemia. The early detection of patients at risk of developing post-operative hypocalcemia allows for prompt supplementation of calcium and Vitamin D in order to prevent symptoms and allows for a safe and timely discharge.

show abstract

“…e clinical treatment of thyroid is mainly surgical resection, which is efficient. At present, basically, the clinical best treatment for thyroid nodules is not controversial, but the scope of surgical resection is on the contrary because different surgical methods cause different recurrent laryngeal nerve injuries to patients after surgery [22]. Recurrent laryngeal nerve injury is a common complication of thyroid surgery, which seriously affects patients' lifestyle and physiological functions after surgery [23], so accurate location of the lesion during thyroidectomy is very important.…”

Section: Discussionmentioning

confidence: 99%

Edge Segmentation Algorithm‐Based Prevention of Recurrent Laryngeal Nerve Injury in Treatment of Thyroid Nodules Using Ultrasound Images

Wang

Zou

Sun

et al. 2021

Scientific Programming

View full text Add to dashboard Cite

The study was aimed to explore the segmentation effects of different algorithms on thyroid nodule ultrasound images, so as to better protect the recurrent laryngeal nerve during thyroid surgery. Specifically, 186 patients with thyroid nodules were selected as the research objects. The segmentation performances of the gradient vector flow (GVF) Snake, Watershed, and Snake algorithms were compared from 6 aspects of image segmentation effects, pixel accuracy (PA), Intersection over Union (IOU) value, algorithm running time, postoperative recurrent laryngeal nerve injury, intraoperative bleeding volume, and postoperative drainage volume. It was found that the average PA value (0.954) and the IOU value (0.866) of the GVF Snake algorithm were obviously higher than those of the other two algorithms. The total incidence of recurrent laryngeal nerve injury based on the GVF Snake algorithm (4.69%) was obviously lower than that of the Snake algorithm (19.35%) and the watershed algorithm (16.13%). The bleeding volume and postoperative drainage volume based on the GVF Snake algorithm were less versus the other two algorithms ( P < 0.05 ). In conclusion, the GVF Snake algorithm demonstrates ideal segmentation effects, which is suggested in the treatment of thyroid nodules to better protect the recurrent laryngeal nerve.

show abstract

Recurrent Laryngeal Nerve Injury After Thyroid Surgery: An Analysis of 11,370 Patients

Cited by 50 publications

References 23 publications

Clarifying optimal outcome measures in intermittent and continuous laryngeal neuromonitoring

Clarifying optimal outcome measures in intermittent and continuous laryngeal neuromonitoring

PTH after Thyroidectomy as a Predictor of Post-Operative Hypocalcemia

Edge Segmentation Algorithm‐Based Prevention of Recurrent Laryngeal Nerve Injury in Treatment of Thyroid Nodules Using Ultrasound Images

Contact Info

Product

Resources

About