Recovery of laryngeal function after intraoperative injury to the recurrent laryngeal nerve
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TLDR
This review aims to provide an update on the current understandings of surgically-induced injury to the laryngeal nerves to clarify any differences between the transient and permanent injury of the RLN.Abstract:
Loss of function in the recurrent laryngeal nerve (RLN) during thyroid/parathyroid surgery, despite a macroscopically intact nerve, is a challenge which highlights the sensitivity and complexity of laryngeal innervation. Furthermore, the uncertain prognosis stresses a lack of capability to diagnose the reason behind the impaired function. There is a great deal of literature considering risk factors, surgical technique and mechanisms outside the nerve affecting the incidence of RLN paresis during surgery. To be able to prognosticate recovery in cases of laryngeal dysfunction and voice changes after thyroid surgery, the surgeon would first need to define the presence, location, and type of laryngeal nerve injury. There is little data describing the events within the nerve and the neurobiological reasons for the impaired function related to potential recovery and prognosis. In addition, very little data has been presented in order to clarify any differences between the transient and permanent injury of the RLN. This review aims, from an anatomical and neurobiological perspective, to provide an update on the current understandings of surgically-induced injury to the laryngeal nerves.read more
Citations
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Timing of Nimodipine Therapy for the Treatment of Vocal Fold Paralysis
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Application of transoral continuous intraoperative neuromonitoring in natural orifice transluminal endoscopic surgery for thyroid disease: a preliminary study.
TL;DR: Cont-IONM is feasible and safe to use during transoral endoscopic thyroidectomies and may assist in the early detection of adverse EMG changes, thereby preventing paralysis of the RLNs.
References
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Clark A. Rosen,Libby J. Smith,VyVy N. Young,Priya Krishna,Matthew F. Muldoon,Michael C. Munin +5 more
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TL;DR: It is revealed that the extent of thyroidectomy impacts voice outcomes in the early postoperative period, and risk factors for late NegVO in post-thyroidectomy patients who should be considered for early voice rehabilitation referral are identified.
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Exploring the phonatory effects of external superior laryngeal nerve paralysis: An In vivo model
TL;DR: By selectively blocking the ESLN with lidocaine HCl (with laryngeal electromyography verification), acute, unilateral cricothyroid muscle dysfunction is modeled to explore possible acoustic, aerodynamic, auditory‐perceptual and auto‐perceptive effects.
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