Preservation of the Laryngeal Nerves during Total Thyroid Lobectomy
Abstract
A technique of exposure and preservation of the recurrent laryngeal nerve at the very onset of thyroidectomy and preservation of the external branch of the superior laryngeal nerve at the close of the procedure is described, which is believed to afford maximum protection to these nerves during total thyroid lobectomy and isthmusectomy as well as total thyroidectomy. At the same time, preservation of the parathyroid glands is achieved. In 120 exposures and preservations of the recurrent laryngeal nerve there have been no instances of a single permanent paralysis of this nerve. In 111 total thyroid lobectomies in which the external branch of the superior laryngeal nerve was placed in jeopardy, only one patient had a slight bowing of the vocal cord with excellent voice function during a limited follow-up period.
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References
1. Kocher T: Zur Pathologie und Therapie des Kropfes. Dtsch Z Chirurg 4: 417–440, 1874.
2. Halsted WS: The operative story of goitre. The author's operation. Johns Hopkins Rep 19: 71–257, 1920.
3. Lahey F: Routine dissection and demonstration recurrent laryngeal nerve in subtotal thyroidectomy. Surg Gynecol Obstet 66: 775, 1938.
4. Thompson NW, Olsen WR, Hoffman GL: The continuing development of the technique of thyroidectomy. Surgery 73: 913–927, 1973.
5. Sedgwick C: Major Problems in Clinical Surgery. Philadelphia, W. B. Saunders Co, 1974, vol 15, pp 1–4; p 182.
6. Kratz RC: The identification and protection of the laryngeal motor nerves during thyroid and laryngeal surgery; a new microsurgical technique. Laryngoscope 33: 59, 1973.
7. Wang C: The use of the inferior cornu of the thyroid cartilage in identifying the recurrent laryngeal nerve. Surg Gynecol Obstet 140: 91–94, 1975.
8. Holt GR, McMurry GT, Joseph DJ: Recurrent laryngeal nerve injury following thyroid operations. Surg Gynecol Obstet 144: 567–570, 1977.
9. Work WP: Unusual position of the right recurrent laryngeal nerve. Ann Otol Rhinol Laryngol 50: 769–775, 1941.
10. Marquez A: Anomalias de nervio recurrente. Bol Sociedad Venezolana de Cirugia 28: 191–197, 1974.
11. Berry J: Suspensory ligaments of the thyroid gland. J Anat 22: 1888. Proc Anat Soc. Gr. Britain and Ireland, p 4, July, 1887.
12. Loré JM Jr.: Atlas of Head and Neck Surgery. Philadelphia, W. B. Saunders Co, ed 1, 1962, p 354, ed 2, 1973, p 618.
13. Curtis GM: The blood supply of the human parathyroids. Surg Gynecol Obstet 51: 805, 1930.
14. Attie JN, Khafif RA: Preservation of parathyroid glands during total lobectomy. Am J Surg 130: 399–404, 1975.
15. Matsura H, Sako K, Marchetta FC: Successful reimplantation of autogenous parathyroid tissue. Am J Surg 118: 779–782, 1969.
16. Reed AF: The relation of the inferior laryngeal nerve to the inferior thyroid artery. Anat Rec 85: 17, 1943.
17. Halsted WS, Evans HM: The parathyroid glandules. Their blood supply and their preservation in operation upon the thyroid gland. Ann Surg 46: 489, 1907.
18. Moosman DA, DeWeese MS: The external laryngeal nerve as related to thyroidectomy. Surg Gynecol Obstet 127: 1011, 1968.
19. Berlin DD: The recurrent laryngeal nerves in total ablation of the normal thyroid gland: An anatomical and surgical study. Surg Gynecol Obstet 60: 19, 1935.
20. Holinger LD, Holinger PC, Holinger PH: Etiology of bilateral abductor vocal cord paralysis. Ann Otol Rhinol Laryngol 85: 428, 1976.
21. Perzik SL: Total thyroidectomy indications, complications and sequelae. Am J Surg 106: 744–747, 1963.
22. Loré JM Jr., Chakar S, Montes M: Parathyroid adenomas causing vocal cord paralysis. Trans Am Acad Ophthalmol Otolaryngol Sept.-Oct., 1972
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Article first published: November-December 1977
Issue published: November-December 1977
PubMed: 596776
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This article was published in Annals of Otology, Rhinology & Laryngology.
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