About: Immediate revision in patients with bilateral recurrent laryngeal nerve palsy after thyroid and parathyroid surgery. How worthy is it?     Goto   Sponge   NotDistinct   Permalink

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  • The aim of the present study was to determine whether immediate revision surgery has benefits for patients with iatrogenic bilateral recurrent laryngeal nerve (RLN) palsy. From January 1, 2004 to January 30, 2011, 29 consecutive patients underwent immediate revision after total thyroidectomy. The cohort comprised 29 patients, 2 males and 27 females, aged 23 to 76 years (median 52 years). Identification of the type and extent of injury of each branch was reported in the protocol, and reconstruction was performed whenever possible. A complete transection of the nerve or one of its branches was found in 14 and 5 nerves, respectively. In three patients, the nerve was completely or partially transected on both sides. Seven anatomically intact nerves were injured by loaded ligature, in one case there was a sign of thermal damage and four nerves showed signs of excessive manipulation (thinning of the nerve trunk). Primary end-to-end anastomosis was performed in seven completely transected RLN and four transected anterior branches of RLN. None of the reconstructed nerve trunks or its branches regained function, although good muscle tone was observed. 23 of 38 intact nerves (61%) regained function, and normal vocalcord mobility on both sides was restored in only four patients. In all cases with regained vocal-cord mobility, functional recovery occurred within 3 months after primary surgery. In conclusion, immediate revision after thyroidectomy may help to indicate the type of RLN damage, which is a predictor of functional recovery and one of major factors influencing future therapeutic management.
  • The aim of the present study was to determine whether immediate revision surgery has benefits for patients with iatrogenic bilateral recurrent laryngeal nerve (RLN) palsy. From January 1, 2004 to January 30, 2011, 29 consecutive patients underwent immediate revision after total thyroidectomy. The cohort comprised 29 patients, 2 males and 27 females, aged 23 to 76 years (median 52 years). Identification of the type and extent of injury of each branch was reported in the protocol, and reconstruction was performed whenever possible. A complete transection of the nerve or one of its branches was found in 14 and 5 nerves, respectively. In three patients, the nerve was completely or partially transected on both sides. Seven anatomically intact nerves were injured by loaded ligature, in one case there was a sign of thermal damage and four nerves showed signs of excessive manipulation (thinning of the nerve trunk). Primary end-to-end anastomosis was performed in seven completely transected RLN and four transected anterior branches of RLN. None of the reconstructed nerve trunks or its branches regained function, although good muscle tone was observed. 23 of 38 intact nerves (61%) regained function, and normal vocalcord mobility on both sides was restored in only four patients. In all cases with regained vocal-cord mobility, functional recovery occurred within 3 months after primary surgery. In conclusion, immediate revision after thyroidectomy may help to indicate the type of RLN damage, which is a predictor of functional recovery and one of major factors influencing future therapeutic management. (en)
Title
  • Immediate revision in patients with bilateral recurrent laryngeal nerve palsy after thyroid and parathyroid surgery. How worthy is it?
  • Immediate revision in patients with bilateral recurrent laryngeal nerve palsy after thyroid and parathyroid surgery. How worthy is it? (en)
skos:prefLabel
  • Immediate revision in patients with bilateral recurrent laryngeal nerve palsy after thyroid and parathyroid surgery. How worthy is it?
  • Immediate revision in patients with bilateral recurrent laryngeal nerve palsy after thyroid and parathyroid surgery. How worthy is it? (en)
skos:notation
  • RIV/00064203:_____/12:8558!RIV13-MZ0-00064203
http://linked.open...avai/predkladatel
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • I, P(NS9901)
http://linked.open...iv/cisloPeriodika
  • 4
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
http://linked.open.../riv/druhVysledku
http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 140538
http://linked.open...ai/riv/idVysledku
  • RIV/00064203:_____/12:8558
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • Bilateral recurrent laryngeal nerve palsy; Immediate revision; Functional recovery; Thyroid surgery (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • IT - Italská republika
http://linked.open...ontrolniKodProRIV
  • [458E6D2CA59F]
http://linked.open...i/riv/nazevZdroje
  • Acta Otorhinolaryngologica Italica
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...vavai/riv/projekt
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 32
http://linked.open...iv/tvurceVysledku
  • Kastner, Jan
  • Betka, Jan
  • Chovanec, Martin
  • Zábrodský, Michal
  • Kuchař, Martin
  • Bouček, Jan
http://linked.open...ain/vavai/riv/wos
  • 000314229000002
issn
  • 0392-100X
number of pages
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