Mechanisms of recurrent laryngeal nerve injury near the nerve entry point during thyroid surgery: A retrospective cohort study.
In: International Journal of Surgery, Jg. 83 (2020-11-01), S. 125-130
Online
academicJournal
Zugriff:
Background: The use of intraoperative neuromonitoring (IONM) for visual identification of recurrent laryngeal nerve (RLN) has decreased the rates of RLN injury (RLNI) during thyroid surgery. However, little attention has been paid to RLNI near the nerve entry point (NEP), where most injuries occur. The aim of this study was to determine the mechanism of RLNI near the NEP and to describe the recovery of nerve function. Methods: Patients undergoing thyroid surgery were analyzed to identify true loss of signal (LOS) by IONM. Follow-up for vocal cord palsy (VCP) was confirmed by a postoperative laryngoscopy. The risk factors for RLNI, the type of RLNI, the prevalence of VCP and the time for VCP recovery were all recorded and analyzed. Results: We analyzed 3582 at-risk nerves in 2257 surgical patients. The overall rate of RLNI near the NEP in at-risk nerves was 3.2%. RLNI was more likely to occur in nerves with extralaryngeal bifurcation (p = 0.013). The distribution of RLNI types, in order of frequency, was traction (52.6%; n = 61), compression (38.8%; n = 45), thermal (7.8%; n = 9), and nerve transection (0.9%; n = 1). Complete recovery from VCP was documented in 93.1% (n = 108) of RLNI. Conclusion: Patients with a bifurcated RLN were at a higher risk of RLNI near the NEP than those without bifurcation. Traction and compression injuries occurred most frequently, but would eventually recover. Excessive stretching of the thyroid lobe played a role in RLNIs near the NEP. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Surgery is the property of Wolters Kluwer Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Mechanisms of recurrent laryngeal nerve injury near the nerve entry point during thyroid surgery: A retrospective cohort study.
|
---|---|
Autor/in / Beteiligte Person: | Liu, Nan ; Chen, Bo ; Li, Luchuan ; Zeng, Qingdong ; Sheng, Lei ; Zhang, Bin ; Liang, Weili ; Lv, Bin |
Link: | |
Zeitschrift: | International Journal of Surgery, Jg. 83 (2020-11-01), S. 125-130 |
Veröffentlichung: | 2020 |
Medientyp: | academicJournal |
ISSN: | 1743-9191 (print) |
DOI: | 10.1016/j.ijsu.2020.08.058 |
Schlagwort: |
|
Sonstiges: |
|