The recurrent laryngeal nerve in thyroid surgery.

The recurrent laryngeal nerve (RLN) is an essential nerve for phonation and psychosocial interaction. Throughout the annals oflaryngological history, vocal cord paralysis has been a well recognised disorder. A rich heritage of scientific investigation and research has considered the complexity of vocal cord function, laryngoscopic presentation and surgical rehabilitation. Identification and preservation of the RLN is the major concern in thyroid surgery. Controversy exists regarding the correct pre- and postoperative management in vocal cord evaluation. We fully review this topic and challenge, in part, the recent Thyroid Clinical Guidelines as published by RCSI.

[1]  D. Sinagra,et al.  Voice changes after thyroidectomy without recurrent laryngeal nerve injury. , 2004, Journal of the American College of Surgeons.

[2]  J. Shah,et al.  Initial results from a prospective cohort study of 5583 cases of thyroid carcinoma treated in the United States during 1996 , 2000, Cancer.

[3]  A. G. D. Maran,et al.  Head and Neck Surgery , 2020, Otolaryngology–Head and Neck Surgery.

[4]  S. Sidhu,et al.  NERVE STIMULATION IN THYROID SURGERY: IS IT REALLY USEFUL? , 2007, ANZ journal of surgery.

[5]  F. R. Miller Surgical anatomy of the thyroid and parathyroid glands. , 2003, Otolaryngologic clinics of North America.

[6]  D. Myssiorek Recurrent laryngeal nerve paralysis: anatomy and etiology. , 2004, Otolaryngologic clinics of North America.

[7]  A. Shaha Routine laryngoscopy in thyroid surgery: A valuable adjunct. , 2007, Surgery.

[8]  A. Curran,et al.  Recurrent laryngeal nerve dysfunction following carotid endarterectomy. , 1997, Journal of the Royal College of Surgeons of Edinburgh.

[9]  B. T. King,et al.  LXXVIII An Anatomical Reason for the Various Behaviors of Paralyzed Vocal Cords , 1948, The Annals of otology, rhinology, and laryngology.

[10]  P. Würl,et al.  Anwendung des Neuromonitoring des N. laryngeus recurrens in der Schilddrüsenchirurgie - eine prospektive Studie , 2002 .

[11]  Robin A. Samlan,et al.  The Utility of Evaluating True Vocal Fold Motion Before Thyroid Surgery , 2006, The Laryngoscope.

[12]  J. Netterville,et al.  Vocal Fold Paralysis following the Anterior Approach to the Cervical Spine , 1996, The Annals of otology, rhinology, and laryngology.

[13]  D. Ellison,et al.  Laryngeal Mask Anesthesia With Intraoperative Laryngoscopy for Identification of the Recurrent Laryngeal Nerve During Thyroidectomy , 2002, The Laryngoscope.

[14]  W. Hollinshead Anatomy for surgeons. , 1969 .

[15]  Eiji Yumoto,et al.  Causes of recurrent laryngeal nerve paralysis. , 2002, Auris, nasus, larynx.

[16]  C. Heitzmann,et al.  Atlas zur Klinik der Kehlkopfkrankheiten , 1866 .

[17]  H. Gharib,et al.  AACE/AAES medical/surgical guidelines for clinical practice: management of thyroid carcinoma. American Association of Clinical Endocrinologists. American College of Endocrinology. , 2001, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[18]  J. Peltier,et al.  Non-recurrent laryngeal nerve related to thyroid surgery: report of three cases , 2007, The Journal of Laryngology & Otology.

[19]  N. Isshiki,et al.  Arytenoid adduction for unilateral vocal cord paralysis. , 1978, Archives of otolaryngology.

[20]  M. Freissmuth,et al.  Neuromonitoring in Thyroid Surgery: Prospective Evaluation of Intraoperative Electrophysiological Responses for the Prediction of Recurrent Laryngeal Nerve Injury , 2004, Annals of Surgery.

[21]  M J Haxer,et al.  Use of speech recognition software: a vocal endurance test for the new millennium? , 2001, Journal of voice : official journal of the Voice Foundation.

[22]  Clerf Lh Unilateral vocal cord paralysis. , 1953 .

[23]  J. Kobler,et al.  Recurrent Laryngeal Nerve Identification and Assessment during Thyroid Surgery: Laryngeal Palpation , 2004, World Journal of Surgery.

[24]  Daniel H. Kim,et al.  Microsurgical Anatomy of the Laryngeal Nerves as Related to Thyroid Surgery , 2002, The Laryngoscope.

[25]  E. Babin,et al.  The recurrent laryngeal nerve: Related vascular anatomy , 1998, The Laryngoscope.

[26]  V. Riddell Injury to recurrent laryngeal nerves during thyroidectomy; a comparison between the results of identification and non-identification in 1022 nerves exposed to risk. , 1956, Lancet.

[27]  R. Otto,et al.  Sensitivity and Specificity of Intraoperative Recurrent Laryngeal Nerve Stimulation in Predicting Postoperative Nerve Paralysis , 2002, The Annals of otology, rhinology, and laryngology.

[28]  B. Lang,et al.  The role of intraoperative neuromonitoring of recurrent laryngeal nerve during thyroidectomy: a comparative study on 1000 nerves at risk. , 2006, Surgery.

[29]  Holt Gr,et al.  Recurrent laryngeal nerve injury following thyroid operations. , 1977 .

[30]  Neck Surgery,et al.  Archives of otolaryngology , 1985 .

[31]  J. Fenton,et al.  Recurrent laryngeal nerve palsy secondary to benign thyroid disease , 1994, The Journal of Laryngology & Otology.

[32]  D. Brasnu,et al.  Paralysies laryngées unilatérales : données épidémiologiques et évolution thérapeutique , 2003 .

[33]  A. Miyauchi,et al.  Sensitivity and Specificity of Intraoperative Recurrent Laryngeal Nerve Stimulation Test for Predicting Vocal Cord Palsy after Thyroid Surgery , 2006, World Journal of Surgery.

[34]  H. Gharib,et al.  Relationship between vocal cord paralysis and benign thyroid disease , 1995, Head & neck.

[35]  M. Shindo,et al.  Surgical Anatomy of the Recurrent Laryngeal Nerve Revisited , 2005, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[36]  G. Gravante,et al.  The Zuckerkandl tubercle. , 2007, American journal of surgery.

[37]  M. Kissin,et al.  Voice changes after thyroidectomy: role of the external laryngeal nerve. , 1984, British medical journal.

[38]  H. Eltzschig,et al.  The use of readily available equipment in a simple method for intraoperative monitoring of recurrent laryngeal nerve function during thyroid surgery: initial experience with more than 300 cases. , 2002, Archives of surgery.

[39]  M. Garcia,et al.  IV. Observations on the human voice , 1856, Proceedings of the Royal Society of London.

[40]  S. Zeitels Adduction arytenopexy with medialization laryngoplasty and cricothyroid subluxation: A new approach to paralytic dysphonia , 1999 .

[41]  G. Randolph,et al.  The importance of preoperative laryngoscopy in patients undergoing thyroidectomy: voice, vocal cord function, and the preoperative detection of invasive thyroid malignancy. , 2006, Surgery.

[42]  D. Myssiorek,et al.  West Nile Virus Induced Vocal Fold Paralysis , 2006, The Laryngoscope.

[43]  P. Yuen,et al.  A prospective evaluation of recurrent laryngeal nerve paralysis during thyroidectomy. , 2000, Archives of surgery.

[44]  H. Hirose Clinical observations on 600 cases of recurrent laryngeal nerve paralysis. , 1978, Auris, nasus, larynx.