Electrophysiological monitoring of the nonrecurrent inferior laryngeal nerve and radiological evaluation of concurrent vascular anomalies

Autor: Ismail Cem Sormaz, Ahmet Yalin Iscan, Fatih Tunca, Mehmet Kostek, Nurcihan Aygun, Tugba Matlim Ozel, Yigit Soytas, Arzu Poyanli, Serkan Sari, Mehmet Uludag, Yasemin Giles Senyurek
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Frontiers in Endocrinology, Vol 15 (2024)
Druh dokumentu: article
ISSN: 1664-2392
DOI: 10.3389/fendo.2024.1420697
Popis: PurposeThe objective of this study was to characterize the electrophysiological characteristics of nonrecurrent inferior laryngeal nerves (NRILNs) that were dissected via intraoperative neuromonitoring (IONM) and concomitant vascular anomalies in patients with NRILNs.MethodsA retrospective analysis was conducted on 7865 patients who underwent thyroidectomy with IONM at three tertiary referral centers. The study included 42 patients in whom an NRILN was detected. IONM data and postoperative vocal cord (VC) examinations were recorded for all patients. The absence of an initial vagal EMG response and/or a short (3.5ms had a large mediastinal goiter. Transient VC paralysis occurred in one (2.4%) patient. Of the 36 patients with postoperative imaging data, 33 (91.4%) had vascular anomalies. All 33 patients had aberrant right subclavian arteries, and 13 (39.4%) also had accompanying additional vascular anomalies.ConclusionThe NRILN is an anatomical variation that increases the risk of nerve injury. Observation of an absent EMG response and/or a short latency period during the initial vagal stimulation facilitates the detection of an NRILN at an early stage of thyroidectomy in the majority of patients.
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