The Superior Laryngeal Nerve and Its Vulnerability in Surgeries of the Neck

Dekhou, Antonio; Morrison, Robert; Gemechu, Jickssa

doi:10.3390/diagnostics11071243

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…The fine size, variable course and label of “the neglected nerve” make the EBSLN at potential risk during thyroidectomy ( 20 , 21 ). Injury to the EBSLN can occur by transection, traction, ligation, thermal damage, and disrupted blood supply ( 22 ), and identification though proper and sufficient exposure is important to avoid this ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

Utility of video-assisted method for identifying and preserving the external branch of the superior laryngeal nerve during thyroidectomy

et al. 2023

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BackgroundThe EBSLN is vulnerable to damage during thyroidectomy, results in voice related complications, negatively affect patient quality of life, routine identification of the EBSLN prior to surgical manipulation is necessary for a complication-free thyroidectomy. We aimed to validate a video-assisted procedure for identifying and preserving the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomy and analyze the EBSLN Cernea classification and the localization of the nerve entry point (NEP) from the insertion of the sternothyroid muscle.MethodsA prospective descriptive study was performed; 134 patients, who scheduled for lobectomy with an intraglandular tumor max diameter ≤ 4 cm and without extrathyroidal extension, were randomly divided into the video-assisted surgery (VAS) and conventional open surgery (COS) groups. We used the video-assisted surgical procedure for visually identifying the EBSLN directly, and compared the differences in the visual identification rate and total identification rate of the two groups. We also measured the localization of the NEP using the insertion of the sternothyroid muscle as a reference.ResultsThere was no statistically significant difference in clinical characteristics between the two groups. The visual identification rate and total identification rate were significantly higher in the VAS group than the COS group (91.04% vs. 77.61%, 100% vs. 89.6%). The EBSLN injury rate was 0 in both groups. The mean vertical distance (VD) of the NEP from the sternal thyroid insertion was 1.18 mm (SD 1.12 mm, range, 0–5 mm), with approximately 88.97% of the results occurring within the 0–2 mm range. The mean horizontal distance (HD) was 9.33 mm (SD 5.03 mm, range, 0–30 mm), with over 92.13% of the results occurring within the 5–15 mm range.ConclusionBoth the visual and total identification rates of the EBSLN were significantly higher in the VAS group. This method provided a good visual exposure rate of the EBSLN, aiding in identifying and protecting the EBSLN during thyroidectomy.

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Section: Discussionmentioning

confidence: 99%

Utility of video-assisted method for identifying and preserving the external branch of the superior laryngeal nerve during thyroidectomy

et al. 2023

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“…Dekhou et al, relatou repercussões clínicas do dano ao nervo laríngeo superior, tais como: perda da capacidade de elevação da frequência vocal devido à perda da inervação motora do músculo cricotireóideo; aumento do risco de aspiração devido à perda do reflexo laríngeo da tosse. O risco de dano ao nervo em procedimentos cirúrgicos deriva, dentre outros motivos, de sua relação próxima com artérias, tais como a tireóidea superior 13 .…”

Section: Discussionunclassified

Morfologia e morfometria do forame tireoidiano da laringe e suas implicações clínico-cirúrgicas

Pacífico¹,

Fonsêca²,

Vasconcelos

et al. 2022

Anais FMO

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Introdução: O forame da tireoide é uma variação anatômica caracterizada por uma abertura na porção póstero-superior da lâmina da cartilagem tireoide da laringe. O conhecimento anatômico sobre as estruturas vasculares e nervosas da região do pescoço, bem como o conhecimento da existência de variações anatômicas, tais como o forame da tireoide são de suma importância para o sucesso cirúrgico. Nessa perspectiva, o presente estudo teve como objetivo investigar a incidência, a morfometria e a morfologia do forame tireóideo da cartilagem tireoide em laringes humanas cadavéricas, bem como discutir as relações cirúrgicas e clínicas decorrentes dessa variação anatômica. Método: Foram selecionadas 100 laringes humanas do acervo de peças cadavéricas do Departamento de Anatomia da UFPE que permitissem a visualização do esqueleto cartilaginoso da laringe, em especial, da cartilagem tireoide da laringe. Resultados: Das 100 (cem) laringes selecionadas, 02 (duas) apresentaram o forame tireoidiano, indicando uma incidência de 2%. Conclusão: O estudo embasou a importância do conhecimento anatômico sobre o forame tireóideo. Observou-se uma incidência de 2% do forame tireóideo, que foi circular medindo 7 mm na cartilagem laríngea com apresentação unilateral e 0,45 mm e 0,5 mm no lado esquerdo e direito, respectivamente, na apresentação bilateral. Ademais, o presente estudo apontou importantes dados morfológicos e morfométricos dessa variação anatômica, que não deve ser negligenciada no momento de procedimentos na região do pescoço.

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“…RLN perform adduction and abduction functions [ 27 ]. The inability to change vocal pitch due to CT motor loss is directly related to SLN dysfunction [ 28 ]. The RLN innervates the thyroarytenoid-lateral cricoarytenoid (TA-LCA) for adduction, whereas the SLN innervates the CT.…”

Section: Introductionmentioning

confidence: 99%

Tissue Engineering as a Promising Treatment for Glottic Insufficiency: A Review on Biomolecules and Cell-Laden Hydrogel

Lokanathan

Baki

et al. 2022

Biomedicines

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Glottic insufficiency is widespread in the elderly population and occurs as a result of secondary damage or systemic disease. Tissue engineering is a viable treatment for glottic insufficiency since it aims to restore damaged nerve tissue and revitalize aging muscle. After injection into the biological system, injectable biomaterial delivers cost- and time-effectiveness while acting as a protective shield for cells and biomolecules. This article focuses on injectable biomaterials that transport cells and biomolecules in regenerated tissue, particularly adipose, muscle, and nerve tissue. We propose Wharton’s Jelly mesenchymal stem cells (WJMSCs), induced pluripotent stem cells (IP-SCs), basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), insulin growth factor-1 (IGF-1) and extracellular vesicle (EV) as potential cells and macromolecules to be included into biomaterials, with some particular testing to support them as a promising translational medicine for vocal fold regeneration.

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The Superior Laryngeal Nerve and Its Vulnerability in Surgeries of the Neck

Cited by 5 publications

References 24 publications

Utility of video-assisted method for identifying and preserving the external branch of the superior laryngeal nerve during thyroidectomy

Utility of video-assisted method for identifying and preserving the external branch of the superior laryngeal nerve during thyroidectomy

Morfologia e morfometria do forame tireoidiano da laringe e suas implicações clínico-cirúrgicas

Tissue Engineering as a Promising Treatment for Glottic Insufficiency: A Review on Biomolecules and Cell-Laden Hydrogel

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