Ligadura segregada de la arteria tiroidea superior. Minimizar la lesión posterior a la tiroidectomía en el rama externa del nervio laríngeo superior. Un nuevo enfoque práctico
Segregated ligation of the superior thyroid artery minimize post-thyroidectomy injury to the external branch of superior laryngeal nerve, a novel practical approach
Prensa méd. argent; 106 (4), 2020
Publication year: 2020
External division of the superior laryngeal nerve supplies the crico-thyroid muscle to excite length and
thickness of the vocal fold. Thus, increasing voice tone. The vicinity with the superior thyroid vessels
sets the external branch of the superior laryngeal nerve in danger every time the superior end of the
thyroid is dissected. Thus, the aim of present study is to assess the rate and complication of external
branch of the superior laryngeal nerve injury post- thyroidectomy when segregated ligation of superior
thyroid vessels closes to thyroid capsule without prior nerve identification and without nerve stimulator
or intraoperative neuro-monitoring. The presented study is a prospective, non- randomized clinical
study included 1450 patients who underwent thyroidectomy which either (total thyroidectomies, near
total thyroidectomies or lobectomy and isthmectomy) in the Department of Surgery/AL-Diawania
Teaching Hospital in Diawania City, Iraq, between January 2000 and February 2018. All patients
underwent thyroidectomy through segregated ligation of superior thyroid artery very closely to thyroid
capsule without prior nerve identification and without nerve stimulator or intraoperative neuromonitoring. Postoperative indirect laryngoscopy vocal cord examination with long term follow up through
physical examination and clinical history to evaluate nerve integrity. In present study, the total cases
with EBSLN injury were 38 (2.6%), in which the transient EBSLN injury occurred in 28 (1.9%) of
patients and permanent injury occurred in 10 (0.7%) of patients and majority of cases with EBSLN
injury were occur in patients with large size goiter 29 (2%) more than small size goiter 9 (0.6%) And
these differences were statistically significant differences, (P<0.005). In addition to, the majority of cases with EBSLN injury were occur in male {25(1.7%)} more than female patients {13(0.9%)} And these
differences were statistically significant differences, (P<0.005). Segregated ligation of superior thyroid
artery is a safe technical option, cost effective, time preserved and need surgical skills to minimized
risk of injury to the external laryngeal nerve