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Journals / Erciyes Medical Journal / 2022 / Cilt: 44 - Sayı: 2

Influence of Recurrent Laryngeal Nerve Variations on Vocal Cord Paralysis

Mehmet ULUDAĞ
Adnan İŞGÖR
Zeynep Gül DEMİRCİOĞLU
Mehmet Taner ÜNLÜ
Nurcihan AYGÜN
İsmail Ethem AKGÜN
Mahmut Kaan DEMİRCİOĞLU
Pages
156–160
Publication Date
2022-10-11
DOI
—
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Conclusion: RLN branching is a potential risk factor for total and transient VCP; awareness of this anatomical variation and complete exposure during thyroid surgery are crucial to the prevention of RLN injury.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Vocal cord paralysis (VCP) due to recurrent laryngeal nerve (RLN) injury is a significant potential complication of thyroid and parathyroid surgery.
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Key Findings & Data:Materials and Methods: The data of 123 patients (95 female, 28 male; mean age: 46+13.6 years), a total of 204 neck sides, who underwent a thyroidectomy and/or a parathyroidectomy performed with intraoperative nerve monitoring between March and December 2015 were evaluated retrospectively.
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Conclusion & Impact:Conclusion: RLN branching is a potential risk factor for total and transient VCP; awareness of this anatomical variation and complete exposure during thyroid surgery are crucial to the prevention of RLN injury.
🔬Design:Research Article
📍Scope:2015 Verileri
⚙️Variables:Domain Parameters

Abstract

Objective: Vocal cord paralysis (VCP) due to recurrent laryngeal nerve (RLN) injury is a significant potential complication of thyroid and parathyroid surgery. The aim of this study was to investigate the influence on VCP of the anatomical relationship of the RLN to the inferior thyroid artery (ITA) and extralaryngeal branching of the RLN. Materials and Methods: The data of 123 patients (95 female, 28 male; mean age: 46+13.6 years), a total of 204 neck sides, who underwent a thyroidectomy and/or a parathyroidectomy performed with intraoperative nerve monitoring between March and December 2015 were evaluated retrospectively. Preoperative and postoperative vocal cord examinations were performed in all cases. RLN branching at a distance of >5 mm with both branches entering the larynx was considered extralaryngeal branching of the nerve. Age, gender, nerve side, RLN branching, and the relationship between the RLN and the ITA were evaluated to assess the possible effect on VCP. Results: Of the 204 neck sides, 11 (5.4%) RLNs developed VCP. Ten cases were temporary (4.9%) and 1 (0.5%) was permanent. There was no significant difference in age, gender, nerve side, or RLN-ITA relationship in the VCP cases. Extralaryngeal branching was detected in 42 (22.7%) of 185 nerves, and the rate of total and transient VCP was significantly higher in branching nerves than in nonbranching nerves (11.9% vs 3.5%, p=0.034; 11.9% vs 2.8%, p=0.030, respectively). Conclusion: RLN branching is a potential risk factor for total and transient VCP; awareness of this anatomical variation and complete exposure during thyroid surgery are crucial to the prevention of RLN injury.

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Cite This Article

ULUDAĞ, M., İŞGÖR, A., DEMİRCİOĞLU, Z. G., ÜNLÜ, M. T., AYGÜN, N., AKGÜN, İ. E., DEMİRCİOĞLU, M. K. (2022). Influence of Recurrent Laryngeal Nerve Variations on Vocal Cord Paralysis. Erciyes Medical Journal, Cilt: 44 - Sayı: 2, 156–160. https://ajindex.com/articles/502170

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References (14)

  1. Nam IC, Park YH. Pharyngolaryngeal symptoms associated with thyroid disease. Curr Opin Otolaryngol Head Neck Surg 2017; 25(6): 469–74
  2. Uludağ M, Tanal M, İşgör A. A review of methods for the preservation of laryngeal nerves during thyroidectomy. Sisli Etfal Hastan Tip Bul 2018; 52(2): 79–91
  3. Jeannon JP, Orabi AA, Bruch GA, Abdalsalam HA, Simo R. Diagnosis of recurrent laryngeal nerve palsy after thyroidectomy: a systematic review. Int J Clin Pract 2009; 63(4): 624–9
  4. Serpell JW. New operative surgical concept of two fascial layers enveloping the recurrent laryngeal nerve. Ann Surg Oncol 2010; 17(6): 1628–36
  5. Chiang FY, Lu IC, Chen HC, Chen HY, Tsai CJ, Hsiao PJ, et al. Anatomical variations of recurrent laryngeal nerve during thyroid surgery: how to identify and handle the variations with intraoperative neuromonitoring. Kaohsiung J Med Sci 2010; 26(11): 575–83
  6. Uludağ M, Yetkin G, Oran EŞ, Aygün N, Celayir F, İşgör A. Extralaryngeal division of the recurrent laryngeal nerve: A common and asymmetric anatomical variant. Turk J Surg 2017; 33(3): 164–8
  7. Uludag M, Isgor A, Yetkin G, Citgez B. Anatomic variations of the non-recurrent inferior laryngeal nerve. BMJ Case Rep 2009; 2009: bcr10.2008.1107
  8. Henry BM, Vikse J, Graves MJ, Sanna S, Sanna B, Tomaszewska IM, et al. Variable relationship of the recurrent laryngeal nerve to the inferior thyroid artery: A meta-analysis and surgical implications. Head Neck 2017; 39(1): 177–86
  9. Henry BM, Vikse J, Graves MJ, Sanna S, Sanna B, Tomaszewska IM, et al. Extralaryngeal branching of the recurrent laryngeal nerve: a meta-analysis of 28,387 nerves. Langenbecks Arch Surg 2016; 401(7): 913–23
  10. Thomas AM, Fahim DK, Gemechu JM. Anatomical variations of the recurrent laryngeal nerve and implications for injury prevention during surgical procedures of the neck. Diagnostics (Basel) 2020; 10(9): 670
  11. Yin C, Song B, Wang X. Anatomical variations in recurrent laryngeal nerves in thyroid surgery. Ear Nose Throat J 2021; 100(10_suppl): 930S–6S
  12. Henry BM, Sanna S, Graves MJ, Vikse J, Sanna B, Tomaszewska IM, et al. The non-recurrent laryngeal nerve: a meta-analysis and clinical considerations. PeerJ 2017; 5: e3012
  13. Yalçin B, Tuğcu H, Cantürk N, Ozan H. Laryngeal branching pattern of the inferior laryngeal nerve, before entering the larynx. Surg Radiol Anat 2006; 28(4): 339–42
  14. Uludag M, Aygun N, Isgor A. Motor function of the recurrent laryngeal nerve: Sometimes motor fibers are al