Place and value of the recurrent laryngeal nerve (RLN) palpatory method in preventing RLN palsy during thyroid surgery
| Autor: | Arpad Juhasz, Balázs Paál, Áron Altorjay, Zsuzsanna Bencsik, Gabor Kecskes, Miklós Rüll, Zoltán Tihanyi, Ferenc Luka |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Palpation Intraoperative Period medicine.artery medicine Recurrent laryngeal nerve Humans Vocal cord paralysis Inferior thyroid artery Palsy medicine.diagnostic_test business.industry Recurrent Laryngeal Nerve Thyroidectomy Neurapraxia Middle Aged medicine.disease Surgery Dissection Otorhinolaryngology Recurrent Laryngeal Nerve Injuries Female business Vocal Cord Paralysis |
| Zdroj: | Headneck. 31(4) |
| ISSN: | 1097-0347 |
| Popis: | Background. In recent years, certain publications have appeared confirming that intraoperative palpation of the recurrent laryngeal nerve (RLN) is a very reliable method. Method. The characteristics of the surgical anatomy of 1023 RLN have been summarized on the basis of intraoperative palpability, running down, branching variations, thickness, and laryngeal entry site. Results. Palpation was helpful in 81.4% (833/1023), proved false positive in 8.2% (84/1023), and in 10.4% (106/1023) it was of no help in the exact localization. Definitive RLN palsy was experienced in 0.78% of all cases (8/1023), while transient paresis was encountered in 1.2% (12/1023). Only a moderately strong stochastic correlation could be found between RLN palsies and those nerves which were nonpalpable and atypical, which showed the joint occurrence of being both thinner than normal and branching already before the plane of the inferior thyroid artery (Cramer's associate coefficient, C = 0.383). Conclusion. Palpation alone cannot substitute visualization and proper surgical dissection of the nerve. © 2008 Wiley Periodicals, Inc. Head Neck, 2009 |
| Databáze: | OpenAIRE |
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