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Usefulness of intraoperative neuromonitoring for preservation of an extralaryngeal bifurcation of the recurrent laryngeal nerve: A case report
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Yano, Masatsgu
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JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan

Saito, Yasufumi
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JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan

Yoshida, Makoto
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JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan

Oshiro, Takafumi
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JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan

Fukda, Toshikatsu
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JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan

Ochi, Makoto
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JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan

Okamoto, Yuzo
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JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan

Ono, Eiji
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JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan

Ohdan, Hideki
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Hiroshima Univ, Dept Gastroenterol & Transplant Surg, Grad Sch Biomed & Hlth Sci, Hiroshima, Japan JR Hiroshima Hosp, Dept Surg, Hiroshima, Japan
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.
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页码:330 / 332
页数:3
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