Usefulness of intraoperative neuromonitoring for preservation of an extralaryngeal bifurcation of the recurrent laryngeal nerve: A case report

被引:1
作者
Yano, Masatsgu [1 ]
Saito, Yasufumi [1 ]
Yoshida, Makoto [1 ]
Oshiro, Takafumi [1 ]
Fukda, Toshikatsu [1 ]
Ochi, Makoto [1 ]
Okamoto, Yuzo [1 ]
Ono, Eiji [1 ]
Ohdan, Hideki [2 ]
机构
[1] JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan
[2] Hiroshima Univ, Dept Gastroenterol & Transplant Surg, Grad Sch Biomed & Hlth Sci, Hiroshima, Japan
来源
INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS | 2018年 / 53卷
关键词
Extralaryngeal bifurcation; Recurrent laryngeal nerve; Thyroid surgery; Neu romonitoring;
D O I
10.1016/j.ijscr.2018.11.009
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: Recurrent laryngeal nerve injury is a major complication of thyroid surgery. An endotracheal tube with electromyography electrodes attached to it was recently developed for intraoperative neuromonitoring during thyroid surgery. Here we describe the successful identification and preservation of an extralaryngeal bifurcation of the recurrent laryngeal nerve by intraoperative neuromonitoring in a patient undergoing thyroid surgery. Presentation of case: A 56-year-old woman presented for evaluation of a neck swelling found during a medical examination. Computed tomography (CT) revealed a tumor with a 5-cm diameter in the left thyroid lobe. Fine needle aspiration cytology revealed a Bethesda category III finding. Left thyroid lobe resection was scheduled. During surgery, the left recurrent laryngeal nerve was found to be adhered to the tumor. Careful exploration and intraoperative neuromonitoring allowed us to identify and preserve an extralaryngeal bifurcation of the recurrent laryngeal nerve. Discussion: The recurrent laryngeal nerve can demonstrate various anomalies and bifurcations. Failure to notice and correctly identify extralaryngeal bifurcation leads to recurrent laryngeal nerve injury. Motor branch injury has a particularly large effect. Intraoperative neuromonitoring has been reported to be useful for identifying and preserving the recurrent laryngeal nerve and its aberrations as well as the external branch of the superior laryngeal nerve during thyroid surgery. Conclusion: The findings from this case suggest that an extralaryngeal bifurcation of the recurrent laryngeal nerve can be identified and safely preserved by intraoperative neuromonitoring. (C) 2018 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.
引用
收藏
页码:330 / 332
页数:3
相关论文
共 21 条
  • [1] Ethical and medicolegal issues in neuromonitoring during thyroid and parathyroid surgery: a review of the recent literature
    Angelos, Peter
    [J]. CURRENT OPINION IN ONCOLOGY, 2012, 24 (01) : 16 - 21
  • [2] External branch of the superior laryngeal nerve monitoring during thyroid and parathyroid surgery: International Neural Monitoring Study Group standards guideline statement
    Barczynski, Marcin
    Randolph, Gregory W.
    Cernea, Claudio R.
    Dralle, Henning
    Dionigi, Gianlorenzo
    Alesina, Piero F.
    Mihai, Radu
    Finck, Camille
    Lombardi, Davide
    Hartl, Dana M.
    Miyauchi, Akira
    Serpell, Jonathan
    Snyder, Samuel
    Volpi, Erivelto
    Woodson, Gayle
    Kraimps, Jean Louis
    Hisham, Abdullah N.
    [J]. LARYNGOSCOPE, 2013, 123 : S1 - S14
  • [3] Randomized Controlled Trial of Visualization versus Neuromonitoring of the External Branch of the Superior Laryngeal Nerve during Thyroidectomy
    Barczynski, Marcin
    Konturek, Aleksander
    Stopa, Magorzata
    Honowska, Agnieszka
    Nowak, Wojciech
    [J]. WORLD JOURNAL OF SURGERY, 2012, 36 (06) : 1340 - 1347
  • [4] Morbidity of thyroid surgery
    Bergamaschi, R
    Becouarn, G
    Ronceray, J
    Arnaud, JP
    [J]. AMERICAN JOURNAL OF SURGERY, 1998, 176 (01) : 71 - 75
  • [5] Does Extralaryngeal Branching Have An Impact on the Rate of Postoperative Transient or Permanent Recurrent Laryngeal Nerve Palsy?
    Casella, Claudio
    Pata, Giacomo
    Nascimbeni, Riccardo
    Mittempergher, Francesco
    Salerni, Bruno
    [J]. WORLD JOURNAL OF SURGERY, 2009, 33 (02) : 261 - 265
  • [6] Detecting and identifying nonrecurrent laryngeal nerve with the application of intraoperative neuromonitoring during thyroid and parathyroid operation
    Chiang, Feng-Yu
    Lu, I-Cheng
    Tsai, Cheng-Jing
    Hsiao, Pi-Jung
    Lee, Ka-Wo
    Wu, Che-Wei
    [J]. AMERICAN JOURNAL OF OTOLARYNGOLOGY, 2012, 33 (01) : 1 - 5
  • [7] Standardization of Intraoperative Neuromonitoring of Recurrent Laryngeal Nerve in Thyroid Operation
    Chiang, Feng-Yu
    Lee, Ka-Wo
    Chen, Hui-Chun
    Chen, Hsiu-Ya
    Lu, I-Cheng
    Kuo, Wen-Rei
    Hsieh, Ming-Chia
    Wu, Che-Wei
    [J]. WORLD JOURNAL OF SURGERY, 2010, 34 (02) : 223 - 229
  • [8] Intraoperative monitoring of the recurrent laryngeal nerve in thyroid surgery
    Dralle, H.
    Sekulla, C.
    Lorenz, K.
    Brauckhoff, M.
    Machens, A.
    [J]. WORLD JOURNAL OF SURGERY, 2008, 32 (07) : 1358 - 1366
  • [9] Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery
    Dralle, H
    Sekulla, C
    Haerting, J
    Timmermann, W
    Neumann, HJ
    Kruse, E
    Grond, S
    Mühlig, HP
    Richter, C
    Voss, J
    Thomusch, O
    Lippert, H
    Gastinger, I
    Brauckhoff, M
    Gimm, O
    [J]. SURGERY, 2004, 136 (06) : 1310 - 1321
  • [10] Epidemiology of Vocal Fold Paralyses after Total Thyroidectomy for Well-Differentiated Thyroid Cancer in a Medicare Population
    Francis, David O.
    Pearce, Elizabeth C.
    Ni, Shenghua
    Garrett, C. Gaelyn
    Penson, David F.
    [J]. OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2014, 150 (04) : 548 - 557