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A Closer Look at Laryngeal Nerves during Thyroid Surgery: A Descriptive Study of 584 Nerves.

Pradeep PV, Jayashree B, Harshita SS - Anat Res Int (2012)

Bottom Line: TZ was Grade 1 in 65.2%, Grade II in 25.1% and Grade III in 9.5%. 31.16% of the RLN passes through the LOB.Conclusions.A thorough knowledge of the laryngeal nerves and anatomical variations is necessary for safe thyroid surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrine Surgery, Narayana Medical College & Superspeciality Hospital, Chinthareddypalem, Nellore 524002, India.

ABSTRACT
Morbidity after thyroidectomy is related to injuries to the parathyroids, recurrent laryngeal (RLN) and external branch of superior laryngeal nerves (EBSLN). Mostly these are due to variations in the surgical anatomy. In this study we analyse the surgical anatomy of the laryngeal nerves in Indian patients undergoing thyroidectomy. Materials and Methods. Retrospective study (February 2008 to February 2010). Patients undergoing surgery for benign goitres, T1, T2 thyroid cancers without lymph node involvement were included. Data on EBSLN types, RLN course and its relation to the TZ & LOB were recorded. Results. 404 thyroid surgeries (180 total & 224 hemithyroidectomy) were performed. Data related to 584 EBSLN and RLN were included (324 right sided & 260 left sided). EBSLN patterns were Type 1 in 71.4%, Type IIA in 12.3%, and Type IIB in 7.36%. The nerve was not seen in 4.3% cases. RLN had one branch in 69.34%, two branches in 29.11% and three branches in 1.36%. 25% of the RLN was superficial to the inferior thyroid artery, 65% deep to it and 8.2% between the branches. TZ was Grade 1 in 65.2%, Grade II in 25.1% and Grade III in 9.5%. 31.16% of the RLN passes through the LOB. Conclusions. A thorough knowledge of the laryngeal nerves and anatomical variations is necessary for safe thyroid surgery.

No MeSH data available.


Related in: MedlinePlus

It depicts type 2 EBSLN. Its course is very close to the superior pole of thyroid.
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fig2: It depicts type 2 EBSLN. Its course is very close to the superior pole of thyroid.

Mentions: A total of 404 patients who underwent thyroid surgery are included in this study. Among these 180 underwent total thyroidectomy (TT) and 224 patients had hemithyroidectomy (HT). There were 324 nerves on the right side and 260 nerves on the left side in this study. The male to female ratio was 1 : 8. The mean age was 37.52 ± 12.9 years and the mean duration of goitre was 39.49 ± 46.82 months. The indications of surgery included Graves disease, toxic multinodular goitre, early carcinoma thyroid, and non toxic benign goitres. A total of 584 EBSLN and RLN were dissected. Type 1 nerve was the commonest among the 324 right-side EBSLN and 260 EBSLN on the left. The different types of EBSLN are depicted in Table 1. 3.4% of the nerves on the left and 5.4% on the right side were not identified. Figure 1 shows type 1 and Figure 2 show type 2 EBSLN.


A Closer Look at Laryngeal Nerves during Thyroid Surgery: A Descriptive Study of 584 Nerves.

Pradeep PV, Jayashree B, Harshita SS - Anat Res Int (2012)

It depicts type 2 EBSLN. Its course is very close to the superior pole of thyroid.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3378964&req=5

fig2: It depicts type 2 EBSLN. Its course is very close to the superior pole of thyroid.
Mentions: A total of 404 patients who underwent thyroid surgery are included in this study. Among these 180 underwent total thyroidectomy (TT) and 224 patients had hemithyroidectomy (HT). There were 324 nerves on the right side and 260 nerves on the left side in this study. The male to female ratio was 1 : 8. The mean age was 37.52 ± 12.9 years and the mean duration of goitre was 39.49 ± 46.82 months. The indications of surgery included Graves disease, toxic multinodular goitre, early carcinoma thyroid, and non toxic benign goitres. A total of 584 EBSLN and RLN were dissected. Type 1 nerve was the commonest among the 324 right-side EBSLN and 260 EBSLN on the left. The different types of EBSLN are depicted in Table 1. 3.4% of the nerves on the left and 5.4% on the right side were not identified. Figure 1 shows type 1 and Figure 2 show type 2 EBSLN.

Bottom Line: TZ was Grade 1 in 65.2%, Grade II in 25.1% and Grade III in 9.5%. 31.16% of the RLN passes through the LOB.Conclusions.A thorough knowledge of the laryngeal nerves and anatomical variations is necessary for safe thyroid surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrine Surgery, Narayana Medical College & Superspeciality Hospital, Chinthareddypalem, Nellore 524002, India.

ABSTRACT
Morbidity after thyroidectomy is related to injuries to the parathyroids, recurrent laryngeal (RLN) and external branch of superior laryngeal nerves (EBSLN). Mostly these are due to variations in the surgical anatomy. In this study we analyse the surgical anatomy of the laryngeal nerves in Indian patients undergoing thyroidectomy. Materials and Methods. Retrospective study (February 2008 to February 2010). Patients undergoing surgery for benign goitres, T1, T2 thyroid cancers without lymph node involvement were included. Data on EBSLN types, RLN course and its relation to the TZ & LOB were recorded. Results. 404 thyroid surgeries (180 total & 224 hemithyroidectomy) were performed. Data related to 584 EBSLN and RLN were included (324 right sided & 260 left sided). EBSLN patterns were Type 1 in 71.4%, Type IIA in 12.3%, and Type IIB in 7.36%. The nerve was not seen in 4.3% cases. RLN had one branch in 69.34%, two branches in 29.11% and three branches in 1.36%. 25% of the RLN was superficial to the inferior thyroid artery, 65% deep to it and 8.2% between the branches. TZ was Grade 1 in 65.2%, Grade II in 25.1% and Grade III in 9.5%. 31.16% of the RLN passes through the LOB. Conclusions. A thorough knowledge of the laryngeal nerves and anatomical variations is necessary for safe thyroid surgery.

No MeSH data available.


Related in: MedlinePlus