Usefulness of CBCT and guidance software for percutaneous embolization of a lymphatic leakage after thyroidectomy for cancer

Ierardi, Anna Maria; Pappalardo, Vincenzo; Liu, Xiaoli; Wu, Che‐Wei; Anuwong, Angkoon; Kim, Hoon Yub; Liu, Renbin; Lavazza, Matteo; Inversini, Davide; Coppola, Andrea; Floridi, Chiara; Boni, Luigi; Carrafiello, Gianpaolo; Dionigi, Gianlorenzo

doi:10.21037/gs.2016.12.13

Cited by 9 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…66% of patients responded to fasting, while the others required re-intervention [ 111 ]. Percutaneous imaging (mostly, ultrasound)—guided techniques helps the identification of the leakage site [ 112 ]. Ethanol sclerotherapy is rather on historical note [ 105 ].…”

Section: Thyroid Conditions and Hs And Lymphocele/chylous Leakagementioning

confidence: 99%

Horner’s Syndrome and Lymphocele Following Thyroid Surgery

Cârșote

Nistor

Popa

et al. 2023

JCM

View full text Add to dashboard Cite

Horner’s syndrome (HS), caused by lesions of the 3-neuron oculosympathetic nerve pathway (ONP), includes the triad: blepharoptosis, miosis and anhidrosis (ipsilateral with ONP damage). Thyroid–related HS represents an unusual entity underling thyroid nodules/goiter/cancer–HS (T-HS), and post-thyroidectomy HS (Tx-HS). We aim to overview Tx-HS. This is a narrative review. We revised PubMed published, full-length, English papers from inception to November 2022. Additionally, we introduced data on post-thyroidectomy lymphocele/chylous leakage (Tx-L), and introduced a new pediatric case with both Tx-HS and Tx-L. Tx-HS: the level of statistical evidence varies from isolated case reports, studies analyzing the large panel of post-thyroidectomy complications reporting HS among the rarest side effects (as opposite to hypocalcemia), or different series of patients with HS due to various disorders, including T-HS/Tx-HS. Tx-HS is related to benign or malignant thyroid conditions, regardless the type of surgery. A pre-operatory rate of T-HS of 0.14%; a post-operatory rate of Tx-HS between 0.03% and 5% (mostly, 0.2%) are identified; a possible higher risk on endoscopic rather than open procedure is described. Incomplete HS forms, and pediatric onset are identified, too; the earliest identification is after 2 h since intervention. A progressive remission is expected in most cases within the first 2–6 months to one year. The management is mostly conservative; some used glucocorticoids and neurotrophic agents. One major pitfall is an additional contributor factor like a local compression due to post-operatory collections (hematoma, cysts, fistula, Tx-L) and their correction improves the outcome. The prognostic probably depends on the severity of cervical sympathetic chain (CSC) lesions: indirect, mild injury due to local compressive masses, intra-operatory damage of CSC like ischemia and stretching of CSC by the retractor associate HS recovery, while CSC section is irreversible. Other iatrogenic contributors to HS are: intra-operatory manipulation of parathyroid glands, thyroid microwave/radiofrequency ablation, and high-intensity focused ultrasound, and percutaneous ethanol injection into thyroid nodules. Tx-L, rarely reported (mostly <0.5%, except for a ratio of 8.3% in one study), correlates with extended surgery, especially lateral/central neck dissection, and the presence of congenitally—aberrant lymphatic duct; it is, also, described after endoscopic procedures and chest-breast approach; it starts within days after surgery. Typically low-fat diet (even fasting and parental nutrition) and tube drainage are useful (as part of conservative management); some used octreotide, local sealing solutions like hypertonic glucose, Viscum album extract, n-Butyl-2-cyanoacrylate. Re-intervention is required in severe cases due to the risk of lymphorrhoea and chylothorax. Early identification of Tx-HS and Tx-L improves the outcome. Some iatrogenic complications are inevitable and a multifactorial model of prediction is still required, also taking into consideration standardized operatory procedures, skillful intra-operatory manipulation, and close post-operatory follow-up of the patients, especially during modern era when thyroid surgery registered a massive progress allowing an early discharge of the patients.

show abstract

Section: Thyroid Conditions and Hs And Lymphocele/chylous Leakagementioning

confidence: 99%

Horner’s Syndrome and Lymphocele Following Thyroid Surgery

Cârșote

Nistor

Popa

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…In these cases, pleural ultrasonography and the installation of a drain seem to be necessary for diagnosis and therapy. [ 27 , 28 ] The drainage shows a milky, cloudy puncture fluid with a high triglyceride content. A chyle leak can cause metabolic disorder through protein loss and a loss of immunoglobulins, vitamins, and electrolytes.…”

Section: Lymph Vessel Injury/ductus Thoracicus/chylothoraxmentioning

confidence: 99%

Lymph node dissection morbidity in thyroid cancer: an integrative review

Pino¹

2021

Sisli Etfal

View full text Add to dashboard Cite

Cervical lymphadenectomy is a common procedure for thyroid cancer. Some of the complications are congruent with the complications of thyroid surgery, in particular recurrent laryngeal nerve paresis and hypoparathyroidism as well as bleeding and wound infection. Specific complications of lateral cervical lymph node dissection are injuries to the accessory, phrenic and hypoglossal nerves, and the cervical plexus trunk and injuries, the salivary glands, and the lymphatic system, especially the ductus thoracicus. Most of these complications are very rare with an incidence of <1%. Profound anatomical knowledge and a careful dissection technique make a decisive contribution to minimizing complications.

show abstract

“…In terms of otolaryngology, CBCT imaging can be used to assess airway, paranasal sinus pathologies, nasal polyps, temporal and frontal bone anatomy, middle ear, and cochlear implantation [9,[65][66][67][68]. As an imaging guidance, CBCT can be used to treat lymphatic leakage after thyroidectomy [69]. The CBCT-based percutaneous image-guided technique may provide mini invasivity and identification of the anatomy and site of the leakage.…”

Section: Otolaryngologymentioning

confidence: 99%

Cone-Beam Computed Tomography for Oral and Maxillofacial Imaging

Tatlı¹,

Evlıce²

2017

Computed Tomography - Advanced Applications

View full text Add to dashboard Cite

The invention of computed tomography (CT) technique revolutionized diagnostic imaging. Compared to conventional X-ray imaging procedures, CT involves higher radiation doses. Recently, cone-beam CT (CBCT) specifically designed for maxillofacial imaging was introduced. CBCT technique is based on a cone-shaped X-ray beam centered on a twodimensional (2D) detector. The detector system performs one rotation around the patient, producing a series of 2D images which are then reconstructed in a 3D data set. The contemporary knowledge regarding CBCT and its proper application guides the practitioner for improvement in diagnostic purposes and treatment planning. The aim of this chapter is to focus on the details, advantages, drawbacks, and clinical applications of CBCT as a headmost CT imaging technique in the oral and maxillofacial (OMF) region. The main clinical applications of CBCT in the OMF region are dentistry including dentoalveolar and maxillofacial surgery, orthodontics, endodontics, and periodontics; and otolaryngology. The aforementioned clinical use of CBCT was described in detail with illustrated sample cases. In most of the cases in OMF region, CBCT takes the place of multi-slice CT. Thus, clinicians should know the clinical applications and capabilities of CBCT technique with its drawbacks.

show abstract

Usefulness of CBCT and guidance software for percutaneous embolization of a lymphatic leakage after thyroidectomy for cancer

Cited by 9 publications

References 20 publications

Horner’s Syndrome and Lymphocele Following Thyroid Surgery

Horner’s Syndrome and Lymphocele Following Thyroid Surgery

Lymph node dissection morbidity in thyroid cancer: an integrative review

Cone-Beam Computed Tomography for Oral and Maxillofacial Imaging

Contact Info

Product

Resources

About