The Identification of Recurrent Laryngeal Nerve by Injection of Blue Dye into the Inferior Thyroid Artery in Elusive Locations

Hepgül, Gülçin; Küçükyılmaz, Meltem; Koc, Oguz; Düzköylü, Yiğit; Sarı, Yavuz Selim; Erbil, Yeşim

doi:10.1155/2013/539274

Cited by 8 publications

(7 citation statements)

References 7 publications

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“…Injection of a blue dye in the inferior thyroid artery when the identifi cation of the recurrent laryngeal nerve was elusive proved to be a useful method in a study done by Gulcin Hepgulet al 8 . However, it was emphasized that it was not a substitution for a conventional visual identifi cation of the nerve.…”

Section: Resultsmentioning

confidence: 99%

Does methylene blue help in the early identification of the recurrent laryngeal nerve?

Chhetri

Bista

et al. 2018

J. Kathmandu Med. Coll.

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Background: Identifi cation of recurrent laryngeal nerve is of utmost importance during thyroid surgery. Different anatomical landmarks have been used to recognize and preserve the nerve. Injury may lead to vocal cord paralysis. Different adjuvant methods have been used to aid in the identifi cation of the nerve. Objective: To determine whether methylene blue smear helps to identify the recurrent laryngeal nerve safely and effi ciently. Methodology: Observational cross sectional study done in 30 patients who underwent different thyroidectomies within a duration of one year. Recurrent laryngeal nerve identifi ed using methylene blue smear and compared with the conventional visualization techniques exercising different known anatomical landmarks. The duration and ease of identifi cation of the nerve was noted and graded. Results: Total of 39 recurrent laryngeal nerves were identifi ed from 28 females and two males. The duration and the ease of dissection of the nerve was inconstant. Earliest time for recognition of the nerve was one and half minutes while the slowest time was 12 minutes.

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Section: Resultsmentioning

confidence: 99%

Does methylene blue help in the early identification of the recurrent laryngeal nerve?

Chhetri

Bista

et al. 2018

J. Kathmandu Med. Coll.

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“…One of the most serious complications of thyroid surgery is injury to the recurrent laryngeal nerve, which varies from 0.5% to 14% depending on the type of disease, the type of surgery, the extent of resection and the surgical technique. [10][11][12] Currently there are three approaches used to identify the nerve: the superior, lateral and inferior approaches. 13 The common component of all three approaches is that the recurrent nerve is identified from the lateral side of the thyroid.…”

Section: Methods Of Identification Of the Nerve Describedmentioning

confidence: 99%

A novel way of identification of recurrent laryngeal nerve during thyroid surgeries

Mathew

2021

Int Surg J

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Background: This was a report of a movement of the recurrent laryngeal nerve which can be demonstrated during thyroid surgeries which can be used for locating the nerve, or identifying it if already exposed and causing confusion with other nearby structures or when alone too.Methods: The nerve is located by observing for a superior-inferior movement of the recurrent laryngeal nerve transmitted by the loose areolar tissue over it and dissecting over this site to locate the nerve right underneath it. This was by direct observation of the movement which will be there so long as the thyroid is held retracted to the opposite side and is not separated from the thyroid at the tissues that constitute the condensation of pre-tracheal fascia called the Berry’s ligament.Results: The recurrent laryngeal nerve originates from the vagus and loops posteriorly and then upwards around the arch of aorta on the left side and the subclavian artery on the right side. When the thyroid gland is retracted away and thus the nerve put on slight stretch, a superior-inferior to and fro- movement of the nerve can be seen. This movement can be used for identification and dissection of the nerve along its course.Conclusions: A review of literature has been done and it is clear that this movement has not been hitherto identified or published

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“…Although this surgery has been performed for many years, recurrent laryngeal nerve (rln) paralysis is still one of the most critical complications and its rate following thyroidectomy is about 1% to 2% [ 1 ]. The damage on the nerve could reach up to 14% [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

The Anatomical Relationship Between Recurrent Laryngeal Nerve and First Tracheal Ring in Males and Females

Akıl

Yollu

Ayral

et al. 2017

Clin Exp Otorhinolaryngol

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ObjectivesDespite the modern advances in thyroid surgery, recurrent laryngeal nerve (rln) paralysis is still a critical problem. In order to decrease the rate of this complication, rln anatomy has been studied intensively. In our study, we aimed to recognize the relationship of rln and landmarks of the first tracheal ring.MethodsEighty-six female and 18 male patients who were undergone total thyroidectomy were included in this study. Trachea vertical height (tvh), right recurrent laryngeal nerve height (rrh), left recurrent laryngeal nerve height (lrh), right recurrent laryngeal nerve to trachea anterior face median raphe distance (rrd), left recurrent laryngeal nerve to trachea anterior face median raphe distance (lrd), right recurrent laryngeal nerve respect to trachea ratio (rrtr), and left recurrent laryngeal nerve respect to trachea ratio (lrtr) parameters of all patients were measured and compared in males and females using independent t-test and measurements on both right and left sides were compared statistically without sex discrimination.ResultsThere were no significant differences between groups in tvh, rrh, rrd, lrd, rrtr, and lrtr parameters. Lrh parameter was significantly higher in males than in females (P<0.04). Comparison of right and left sides revealed that lrh was significantly higher than rrh (P<0.001), lrd was significantly higher than rrd (P<0.001), and rrtr was significantly higher than lrtr (P<0.001).ConclusionIn this study, we have shown that in all cases the rln was located around the lower half of trachea vertical length and at this level left rln was located significantly deeper than the right side.

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The Identification of Recurrent Laryngeal Nerve by Injection of Blue Dye into the Inferior Thyroid Artery in Elusive Locations

Cited by 8 publications

References 7 publications

Does methylene blue help in the early identification of the recurrent laryngeal nerve?

Does methylene blue help in the early identification of the recurrent laryngeal nerve?

A novel way of identification of recurrent laryngeal nerve during thyroid surgeries

The Anatomical Relationship Between Recurrent Laryngeal Nerve and First Tracheal Ring in Males and Females

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