Clinical and Anatomical Factors Affecting Recurrent Laryngeal Nerve Paralysis During Thyroidectomy via Intraoperative Nerve Monitorization

Aygün, Nurcihan; Kostek, Mehmet; Unlu, Mehmet Taner; İşgör, Adnan; Uludağ, Mehmet

doi:10.3389/fsurg.2022.867948

Cited by 7 publications

(4 citation statements)

References 41 publications

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“…Rates of RLN injury were comparable between cohorts. This finding was not unexpected since if it occurs, it is likely almost entirely related to iatrogenic factors or tumor factors 34 . Operative techniques, such as the use of neuromonitoring, could be a potential confounder, which is not known in the database 35 .…”

Section: Discussionmentioning

confidence: 85%

“…This finding was not unexpected since if it occurs, it is likely almost entirely related to iatrogenic factors or tumor factors. 34 Operative techniques, such as the use of neuromonitoring, could be a potential confounder, which is not known in the database. 35 Rates of mortality, sepsis, tracheostomy, and respiratory dependence were higher in patients with hypoalbuminemia, but could not be compared because of 1 cohort having a n ≤ 10.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative Serum Albumin as Predictor of Outcomes After Thyroidectomy

Sciscent,

Eberly,

Lorenz

et al. 2024

OTO Open

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ObjectiveAlbumin is considered to be a surrogate marker for inflammation and nutritional status. Levels usually decrease after surgery but little is known about the predictive value of preoperative albumin levels in patients undergoing thyroidectomy. This study aimed to investigate the 30‐day incidence of postoperative outcomes in thyroidectomy patients with and without preoperative hypoalbuminemia.Study DesignRetrospective cohort study.SettingTriNetX Database.MethodsTriNetX, a federated deidentified database, was retrospectively queried to identify patients who underwent thyroidectomy. Postoperative outcomes within 30 days of thyroidectomy, based on International Classification of Disease, 10th Revision and Current Procedural Terminology codes, in patients with preoperative hypoalbuminemia (≤3.4 g/dL) (cohort 1) were analyzed and compared to patients without hypoalbuminemia (cohort 2).ResultsAfter propensity score matching, 2398 patients were identified in each cohort. Hypoalbuminemia patients were more likely to have postoperative pneumonia (odds ratio, OR: 3.472, 95% confidence interval, CI [2.016‐5.978]), acute renal failure (OR: 3.872, 95% CI [2.412‐6.217]), venous thromboembolism (OR: 1.766, 95% CI [1.016‐2.819]), and surgical site infection (OR: 2.353, 95% CI [1.282‐4.32]). Rates of recurrent laryngeal nerve injury were comparable between cohorts.ConclusionPatients undergoing thyroidectomy with preoperative hypoalbuminemia have a higher prevalence of postoperative complications compared to patients without preoperative hypoalbuminemia. While not routinely assessed, preoperative evaluation of serum albumin levels may help guide expectations and optimal management of thyroidectomy patients.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Preoperative Serum Albumin as Predictor of Outcomes After Thyroidectomy

Sciscent,

Eberly,

Lorenz

et al. 2024

OTO Open

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“…Secondary thyroidectomy and Berry entrapment of recurrent laryngeal nerve were recorded as independent risk factors for overall vocal cord paralysis. Moreover, secondary thyroidectomy and nerve branching were independent risk factors for temporary vocal cord paralysis ( 22 ). RLNI was recorded in 4.6% of cases of which 75 % were females and 25 % were males.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Recurrent Laryngeal Nerve Insult Incidence Post Thyroidectomy for Benign and Malignant Lesions

Haddadin,

Mahasna,

Abumekhleb

et al. 2023

Med Arch

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Background: Vocal cord paresis or paralysis caused by insult to the recurrent laryngeal nerve is one of the main hazards in thyroid surgery. The frequency of recurrent laryngeal nerve palsy varies between 1.5–20%. Hoarseness is found with unilateral recurrent laryngeal nerve insult (RLNI). Bilateral insult produces dyspnea and life-threatening glottal obstruction. The frequency of insult is more in re-do surgeries, Graves’ disease, and thyroid carcinoma operations. Objective: This study aimed to evaluate the risk factors of RLNI in thyroid surgery for benign or malignant lesions. Methods: This retrospective investigation recruited 255 participants of both genders, aged 21–59 yrs. (average 39 yrs.), who were scheduled for thyroid surgery at King Hussein Hospital, King Hussein Medical City, Amman, Jordan, from October 2019 to October 2022. An indirect laryngoscopic examination was done for all participants pre and post surgery. Factors of RLNI such as benign or malignant lesions and type of surgery were investigated. Significance was tested with the chi-square test. A P-value of < 0.05 was considered significant. Results: RLNI was recorded in 25/255 patients (9.8%) following thyroidectomy. Temporary unilateral vocal cord insult was recorded in 17/255 (6.7%) participants out of which it became permanent for 3/255 (1.2%) participants. Bilateral vocal cord insult was recorded in 8/255 (3.1%) participants but did not become permanent for any of them (P < 0.05). A remarkable increase in the frequency of RLNI was found in total/near-total thyroidectomy patients (7/27, 25.9%) compared to patients with bilateral or unilateral subtotal thyroidectomy(18/228, 7.9%; P < 0.05), in malignant lesions (18/105, 17.1%) compared to in benign lesions(7/150, 4.7%; P < 0.05), and in men (9/74, 12.2%) compared to in women(16/181, 8.8%; P < 0.05). Conclusion: Thyroid carcinoma, total thyroidectomy, and male sex were correlated with a remarkable risk of surgical RLNI.

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“…[ 11 ] Although many clinical factors such as SG, recurrent goiter, Basedow Graves’ disease can be predicted preoperatively, RLN variations that may increase the risk of VCP cannot be predicted preoperatively. [ 12 , 13 ]…”

Section: Ionm and Carotid Sheathmentioning

confidence: 99%

Surgical treatment of substernal goiter part 2: cervical and extracervical approaches, complications

Uludağ¹

2022

Sisli Etfal

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The most appropriate treatment of substernal goiter (SG) is surgery. These patients should be evaluated carefully and multidisciplinary in pre-operative period and surgical management should be planned preoperatively. Although most of the SGs can be resected by the cervical approach, an extracervical approach may be required in a small proportion of patients. Surgical complications of SG related to thyroidectomy are higher than other thyroidectomies. In addition to the complications related to thyroidectomy, complications related to the type of surgical intervention may also occur in SG. The patients who may be needed extracervical approaches should be consulted with thorax surgeons, cardiovascular surgeons, and anesthesiologists preoperatively; the surgical management should be planned together. In this part, we aimed to evaluate the cervical approach methods, extracervical approach methods, technical details, and complications in detail.

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Clinical and Anatomical Factors Affecting Recurrent Laryngeal Nerve Paralysis During Thyroidectomy via Intraoperative Nerve Monitorization

Cited by 7 publications

References 41 publications

Preoperative Serum Albumin as Predictor of Outcomes After Thyroidectomy

Preoperative Serum Albumin as Predictor of Outcomes After Thyroidectomy

Comparison of Recurrent Laryngeal Nerve Insult Incidence Post Thyroidectomy for Benign and Malignant Lesions

Surgical treatment of substernal goiter part 2: cervical and extracervical approaches, complications

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