SURGICAL ANATOMY OF EXTERNAL LARYNGEAL NERVE IN RELATION TO THYROID SURGERY : OUR EXPERIENCE

Dr Brajendra Baser, Dr Vishal Rattan Munjal, Dr Manya Thakur Roy

Abstract


Objectives - To Study Surgical Anatomy of External Laryngeal Nerve and it’s variation in relation to Thyroid Surgery.

Methodology – A Non-randomized prospective Study was conducted in patients undergoing Thyroid surgery in SAIMS, Indore. The ELN was identified and preserved intra operatively. The function of Nerve was assessed and documented by pre op & post op EGG and Video laryngoscopy.

Results- Intraoperative identification of ELN leads to almost negligible changes in voice quality. A permanent drop in Fundamental Frequency (Fo) was seen in significant number of patients when the nerve was not identified during surgery.

Conclusion - Today in the era of 21st century where we are reaching new horizons, efforts to further refine thyroid surgery continues. Good range of voice is not only important for Singers but for Teachers, Politicians, RJ, public speakers etc too. An attempt to preserve External Laryngeal Nerve should be done to preserve Voice Quality as an integral part of surgery.


Keywords


External Laryngeal Nerve,Voice Quality, Thyroid Surgery, Superior Thyroid Pedicle, Fundamental Frequency

Full Text:

PDF

References


(1) E N. Aina And A.N. Hisham External Laryngeal Nerve In Thyroid Surgery: Recognition And Surgical Implications;Anz J. Surgery;Volume 71 ; 211-213;Nov-2001

(2) Standring S, Berkovitz Bkb. Thyroid Gland. In: Standring S, Ellis H, Healey Jc, Johnson D, Williams A, Collins P Et Al (Eds) Gray’s Anatomy, 39th Edition, London; Churchill Livingstone, 2005:560-564.

(3) Georgina Magoma, Hassan Saidi- Relation Of The External Laryngeal Nerve To Superior Thyroid Artery In An African Population;Anatomy Journal Of Africa;28-30;June 2013

(4) Seong-Bae Hwang,Hye-Yoon Lee- The Anatomy Of The External Branch Of The Superior Laryngeal Nerve In Koreans;April 2012;1-7

(5) Anand Kumar Mishra, Hema Temadari- Indian Journal Of Medical Sciences;Volume 61;Jan-2007;36

(6) Choksy Sa, Nicholson Ml. 1996. Prevention Of Voice Change In Singers Undergoing Thyroidectomy By Using A Nerve Stimulator To Identify The External Laryngeal Nerve. Br J Surg 83:1131– 1132.

(7) Cernea Cr, Ferraz Ar, Nishio S, Dutra A Jr, Hojaij Fc, Dos Santos Lr. 1992b. Surgical Anatomy Of The External Branch Of The Superior Laryngeal Nerve. Head Neck 14:380–383.

(8) Aina En, Hisham An. 2001b. External Laryngeal Nerve In Thyroid Surgery: Recognition And Surgical Implications. Aust Nz J Surg 71:212–214.

(9) Cernea Cr, Ferraz Ar, Nishio S. Surgical Anatomy Of The External Branch Of The Superior Laryngeal Nerve. Head Neck. 1992;14(5):380-3.

(10) Jansson S, Tisell Le, Hagne I, Sanner E, Stenborg R, Svensson P. Partial Superior Laryngeal Nerve (Sln) Lesions Before And After Thyroid Surgery. World J Surg 1988; 12: 521-7

(11) Friedman M, Toriumi Dm. 1986. Functional Identification Of The External Laryngeal Nerve During Thyroidectomy. Laryngoscope 96:1291–1292

(12) Mishra Ak, Temadari H, Singh N, Mishra Sk, Agarwal A. The External Laryngeal Nerve In Thyroid Surgery: The 'No More Neglected' Nerve. Indian J Med Sci. 2007;61(1):3-8.

(13) Nitin A, Pagedar Md, Jeremy L, Freeman Md. Frcsc, “External Branch Of The Superior Laryngeal Nerve”. Arch Otolaryngol Head Neck Surg. 2009;135(4):360-2.

(14) Aina En, Hisham An. External Laryngeal Nerve In Thyroid Surgery: Recognition And Surgical Implications. Anz J. Surg. 2001;71:212-4


Refbacks

  • There are currently no refbacks.