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Palpatory method used to identify the recurrent laryngeal nerve during thyroidectomy
F Procacciante1, P Picozzi, M Pacifici
1Department of VII Patologia Chirurgica, Policlinico Umberto I, Università degli Studi di Roma La Sapienza, Rome, Italy. procacciante@axrma.uniroma1.it
World Journal of Surgery
|April 29, 2000
Summary
A new palpation technique helps surgeons easily identify the recurrent laryngeal nerve (RLN) during thyroid surgery. This method enhances safety and reduces the risk of nerve injury, a common complication.
Area of Science:
- Surgical Anatomy
- Otolaryngology
- Endocrinology
Background:
- Recurrent laryngeal nerve (RLN) injury is a significant complication in thyroid surgery, occurring in 1-6% of cases.
- Identifying the RLN is crucial for preventing vocal cord paralysis.
- Traditional methods can be challenging, especially in the vicinity of the inferior thyroid artery.
Purpose of the Study:
- To describe and evaluate a simple palpation method for identifying the recurrent laryngeal nerve (RLN) during thyroidectomy.
- To assess the efficacy and safety of this technique in cadavers and patients.
Main Methods:
- A palpation technique involving nerve traction was developed.
- The method was tested on 47 human cadavers.
- The technique was applied in 45 patients undergoing thyroidectomy for benign thyroid diseases.
Main Results:
- The recurrent laryngeal nerve (RLN) was successfully identified in all cadavers.
- The RLN was identified in 52 out of 55 attempts during patient thyroidectomies.
- Postoperative laryngoscopy confirmed normal laryngeal motility in all patients.
Conclusions:
- This simple palpation method facilitates easier and safer identification of the recurrent laryngeal nerve (RLN).
- Integrating this technique before dissection near the inferior thyroid artery reduces the risk of nerve injury.
- The method proved effective in both cadaveric and clinical settings, improving surgical safety.