The possibilities for the restoration of the laryngeal function: the current state-of-the-art

Решетов, И. В.; Polunin, G V; Ananichuk, Anna; Li, Ippolitov; Коваленко, А. А.

doi:10.17116/otorino201782618-23

Cited by 2 publications

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References 33 publications

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“…ORIGINAL STUDY Эндокринная хирургия / Endocrine Surger y | 5 ОБОСНОВАНИЕ Гортань человека с физиологической точки зрения представляет собой сложный «узловой» орган, обеспечивающий одновременно дыхание, пищеотведение и формирование голоса [1][2][3]. Основным регулятором этой деятельности является возвратный гортанный нерв (ВГН) (исключение составляет лишь перстнещитовидная мышца, иннервацию которой осуществляет наружная ветвь верхнего гортанного нерва).…”

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“…Еще одним феноменом, требующим дополнительного объяснения, является реиннервация гортани. Какова роль экстраларингеальных, интраларингеальных ветвей ВГН и верхнего гортанного нерва в этой патологической картине, остается загадкой [3,6,9]. В 2013 г. Американской академией отоларингологии опубликованы результаты хирургического лечения 25 000 пациентов с патологией щитовидной железы (ЩЖ).…”

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Extralaryngeal branching of the recurrent laryngeal nerve. Autopsy case series

et al. 2021

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Background. The thesis «thyroid surgery is the surgery of the recurrent laryngeal nerve», which was defined in the XX century, remains relevant to this day. Thus, despite the use of modern scientific and technological achievements, vocal cord paresis is diagnosed on average in 9.8% patients after thyroid and parathyroid surgery.According to many authors, the main problem which a surgeon encounters is a difficult and sometimes individual anatomy of the recurrent laryngeal nerve. For example, in one study authors identified 28 variants of relationships between the recurrent laryngeal nerve and the inferior thyroid artery. In a recent meta-analysis, it was noted that the frequency of extralaryngeal branching remains underestimated and reaches 73% of cases. Anatomical variants of the recurrent laryngeal nerve or its thin branches, which have not been noticed in time, can lead to inevitable consequences — to nerve injury and a laryngeal dysfunctions, and if anatomical features are not detected on both sides — to a tragedy.Aim. The aim of this study is to determine anatomical variants of the extralaryngeal branches of the recurrent laryngeal nerve and their frequency in autopsy case series.Materials and methods. 46 (100%) recurrent laryngeal nerves were dissected in 23 cadavers. Their path was traced, their relationships with the inferior thyroid artery were determined, and the extralaryngeal branches of the recurrent laryngeal nerve were identified.Results. Few extralaryngeal branches of the recurrent laryngeal nerve were identified during dissection: tracheoesophageal branches, laryngeal branches, aberrant branches. Tracheoesophageal branches were determined in all cadavers. In 37 (80.4%) cases the recurrent laryngeal nerve had got two or more extralaryngeal laryngeal branches. In 6 (13.0%) cases aberrant branches were presented.The inferior thyroid artery was detected in 42 (91.3%) cases. The vessel was in close location with the recurrent laryngeal nerve, forming a neuro-arterial chiasm. In 39.1% of cases the recurrent laryngeal nerve was located between the branches of the inferior thyroid artery, in 39.1% of cases — deeper than the artery, and in 10.9% of cases — more superficial than the artery.Conclusion. The variable anatomical configuration of the recurrent laryngeal nerve inevitably causes difficulties during intraoperative nerve dissection. Tardy identification of these anatomical features can lead to the injury of nerves or its branches, which determines the amount of postoperative vocal cord paresis.

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Extralaryngeal branching of the recurrent laryngeal nerve. Autopsy case series

et al. 2021

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Early comprehensive rehabilitation of patient with postoperative dysphagia

Magomed-Eminov

Uklonskaya

et al. 2022

MES

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Postoperative paresis and paralysis of the larynx, associated with breathing, voice and swallowing disorders, are actual problem of surgical treatment of the thyroid and mediastinal diseases. Traditionally, more attention is paid to phonation disorders treatment. Swallowing recovery methods are not described sufficiently. The paper reports a clinical case of early speech therapy intervention aimed at alleviating postoperative dysphagia caused by the limited flexibility of the larynx. Detailed swallowing disorder diagnosis in patient was carried out before and after the logopaedic correction of dysphagia. The main directions and results of the correctional and pedagogical work with psychological support within comprehensive rehabilitation are described. The findings confirm the need for correctional impact during the early stages of rehabilitation in case of dysphagia in surgical patients with the paresis or paralysis of the larynx.

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The possibilities for the restoration of the laryngeal function: the current state-of-the-art

Cited by 2 publications

References 33 publications

Extralaryngeal branching of the recurrent laryngeal nerve. Autopsy case series

Extralaryngeal branching of the recurrent laryngeal nerve. Autopsy case series

Early comprehensive rehabilitation of patient with postoperative dysphagia

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