Outcome with immediate direct anastomosis of recurrent laryngeal nerves injured during thyroidectomy
Objectives/Hypothesis Management of unrecognized recurrent laryngeal nerve injury typically entails delayed phonosurgical intervention and laryngeal reinnervation, but in cases of recognized injury, nerve anastomosis has been considered standard management. However, the well‐organized outcome analys...
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| Veröffentlicht in: | The Laryngoscope 2014-06, Vol.124 (6), p.1402-1408 |
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| container_title | The Laryngoscope |
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| creator | Hong, Jong W. Roh, Tai S. Yoo, Han-Su Hong, Hyun J. Choi, Hong-Shik Chang, Hang S. Park, Cheong S. Kim, Young S. |
| description | Objectives/Hypothesis
Management of unrecognized recurrent laryngeal nerve injury typically entails delayed phonosurgical intervention and laryngeal reinnervation, but in cases of recognized injury, nerve anastomosis has been considered standard management. However, the well‐organized outcome analysis of nerve anastomosis has been insufficient. We performed immediate direct anastomosis of recurrent laryngeal nerves injured during surgery for thyroid cancer, and subsequent patient outcomes were analyzed.
Study Design
A total 14 patients sustaining recurrent laryngeal nerve injury during thyroidectomy were recruited for the study. Patients undergoing immediate direct reparative anastomosis of the injured nerves constituted the test group, whereas the controls of group 2 (n = 4) did not.
Methods
At follow‐up, all patients submitted to rigid laryngoscopy at 3, 6, and 12 months postoperatively. Subjective and objective outcomes of the two groups were then compared.
Results
At 12 months postoperatively, group 1 showed greater improvement in maximum phonation time, glottic gap scores, GRBAS (grade, roughness, breathiness, asthenia, and strain) scales, aspiration scoring, and Voice Handicap Index than controls of group 2. Moreover, group 1 showed an improvement in all five categories at 12 months postoperatively, compared with status at 3 months. None of the patients in group 1 showed laryngoscopic evidence of vocal cord atrophy.
Conclusion
In this study, patients undergoing immediate direct recurrent laryngeal nerve anastomosis demonstrated better phonation and perceptually rated voice quality than those who did not undergo repair.
Level of Evidence
3b. Laryngoscope, 124:1402–1408, 2014 |
| doi_str_mv | 10.1002/lary.24450 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1530319264</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1530319264</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3950-a3204351a2c934ac112e870c00d1307b4894429e84548118e47b8f8de58dd9c13</originalsourceid><addsrcrecordid>eNp9kE1vFCEYgInR2LV68QcYEi_GZCovHzNwbBqtJhsbTU3VC2GHd1vWmaECY91_L-u2PXjwRALP-wAPIc-BHQFj_M3g0vaIS6nYA7IAJaCRxqiHZFEPRaMV_3pAnuS8YQw6odhjcsAlgGxbsyD-bC59HJHehHJFwziiD64g9SFhX6ibXC5xjDlkGte07s0p4VTo7s7pEt1AJ0y_MNMwbeaEnvo5hemSlqttisFXRxy3T8mjtRsyPrtdD8mXd2_PT943y7PTDyfHy6YXRrHGCc6kUOB4b4R0PQBH3bGeMQ-CdSupjZTcoJZKagCNslvptfaotPemB3FIXu291yn-nDEXO4bc4zC4CeOcbW3DBBjeyoq-_AfdxDlN9XWV4loBZ8ZU6vWe6lPMOeHaXqcw1q9bYHbX3u462L_tK_ziVjmvasZ79C52BWAP3IQBt_9R2eXx52930mY_E3LB3_czLv2wbSc6ZS8-nlowum0vPn235-IPO5OeOA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1528512099</pqid></control><display><type>article</type><title>Outcome with immediate direct anastomosis of recurrent laryngeal nerves injured during thyroidectomy</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Hong, Jong W. ; Roh, Tai S. ; Yoo, Han-Su ; Hong, Hyun J. ; Choi, Hong-Shik ; Chang, Hang S. ; Park, Cheong S. ; Kim, Young S.</creator><creatorcontrib>Hong, Jong W. ; Roh, Tai S. ; Yoo, Han-Su ; Hong, Hyun J. ; Choi, Hong-Shik ; Chang, Hang S. ; Park, Cheong S. ; Kim, Young S.</creatorcontrib><description>Objectives/Hypothesis
Management of unrecognized recurrent laryngeal nerve injury typically entails delayed phonosurgical intervention and laryngeal reinnervation, but in cases of recognized injury, nerve anastomosis has been considered standard management. However, the well‐organized outcome analysis of nerve anastomosis has been insufficient. We performed immediate direct anastomosis of recurrent laryngeal nerves injured during surgery for thyroid cancer, and subsequent patient outcomes were analyzed.
Study Design
A total 14 patients sustaining recurrent laryngeal nerve injury during thyroidectomy were recruited for the study. Patients undergoing immediate direct reparative anastomosis of the injured nerves constituted the test group, whereas the controls of group 2 (n = 4) did not.
Methods
At follow‐up, all patients submitted to rigid laryngoscopy at 3, 6, and 12 months postoperatively. Subjective and objective outcomes of the two groups were then compared.
Results
At 12 months postoperatively, group 1 showed greater improvement in maximum phonation time, glottic gap scores, GRBAS (grade, roughness, breathiness, asthenia, and strain) scales, aspiration scoring, and Voice Handicap Index than controls of group 2. Moreover, group 1 showed an improvement in all five categories at 12 months postoperatively, compared with status at 3 months. None of the patients in group 1 showed laryngoscopic evidence of vocal cord atrophy.
Conclusion
In this study, patients undergoing immediate direct recurrent laryngeal nerve anastomosis demonstrated better phonation and perceptually rated voice quality than those who did not undergo repair.
Level of Evidence
3b. Laryngoscope, 124:1402–1408, 2014</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.24450</identifier><identifier>PMID: 24114669</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Anastomosis, Surgical - methods ; Carcinoma, Papillary - pathology ; Carcinoma, Papillary - surgery ; Cohort Studies ; direct nerve anastomosis ; Female ; Follow-Up Studies ; Humans ; Iatrogenic Disease ; immediate nerve anastomosis ; Injured recurrent laryngeal nerve ; Intraoperative Complications - diagnosis ; Intraoperative Complications - surgery ; Laryngoscopy - methods ; Male ; Middle Aged ; Phonation - physiology ; Reconstructive Surgical Procedures - methods ; Recurrent Laryngeal Nerve Injuries - etiology ; Recurrent Laryngeal Nerve Injuries - surgery ; Retrospective Studies ; Speech disorders ; Thyroid Neoplasms - pathology ; Thyroid Neoplasms - surgery ; Thyroidectomy - adverse effects ; Thyroidectomy - methods ; Time Factors ; Treatment Outcome ; Voice Quality</subject><ispartof>The Laryngoscope, 2014-06, Vol.124 (6), p.1402-1408</ispartof><rights>2013 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3950-a3204351a2c934ac112e870c00d1307b4894429e84548118e47b8f8de58dd9c13</citedby><cites>FETCH-LOGICAL-c3950-a3204351a2c934ac112e870c00d1307b4894429e84548118e47b8f8de58dd9c13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.24450$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.24450$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24114669$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hong, Jong W.</creatorcontrib><creatorcontrib>Roh, Tai S.</creatorcontrib><creatorcontrib>Yoo, Han-Su</creatorcontrib><creatorcontrib>Hong, Hyun J.</creatorcontrib><creatorcontrib>Choi, Hong-Shik</creatorcontrib><creatorcontrib>Chang, Hang S.</creatorcontrib><creatorcontrib>Park, Cheong S.</creatorcontrib><creatorcontrib>Kim, Young S.</creatorcontrib><title>Outcome with immediate direct anastomosis of recurrent laryngeal nerves injured during thyroidectomy</title><title>The Laryngoscope</title><addtitle>The Laryngoscope</addtitle><description>Objectives/Hypothesis
Management of unrecognized recurrent laryngeal nerve injury typically entails delayed phonosurgical intervention and laryngeal reinnervation, but in cases of recognized injury, nerve anastomosis has been considered standard management. However, the well‐organized outcome analysis of nerve anastomosis has been insufficient. We performed immediate direct anastomosis of recurrent laryngeal nerves injured during surgery for thyroid cancer, and subsequent patient outcomes were analyzed.
Study Design
A total 14 patients sustaining recurrent laryngeal nerve injury during thyroidectomy were recruited for the study. Patients undergoing immediate direct reparative anastomosis of the injured nerves constituted the test group, whereas the controls of group 2 (n = 4) did not.
Methods
At follow‐up, all patients submitted to rigid laryngoscopy at 3, 6, and 12 months postoperatively. Subjective and objective outcomes of the two groups were then compared.
Results
At 12 months postoperatively, group 1 showed greater improvement in maximum phonation time, glottic gap scores, GRBAS (grade, roughness, breathiness, asthenia, and strain) scales, aspiration scoring, and Voice Handicap Index than controls of group 2. Moreover, group 1 showed an improvement in all five categories at 12 months postoperatively, compared with status at 3 months. None of the patients in group 1 showed laryngoscopic evidence of vocal cord atrophy.
Conclusion
In this study, patients undergoing immediate direct recurrent laryngeal nerve anastomosis demonstrated better phonation and perceptually rated voice quality than those who did not undergo repair.
Level of Evidence
3b. Laryngoscope, 124:1402–1408, 2014</description><subject>Adult</subject><subject>Aged</subject><subject>Anastomosis, Surgical - methods</subject><subject>Carcinoma, Papillary - pathology</subject><subject>Carcinoma, Papillary - surgery</subject><subject>Cohort Studies</subject><subject>direct nerve anastomosis</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Iatrogenic Disease</subject><subject>immediate nerve anastomosis</subject><subject>Injured recurrent laryngeal nerve</subject><subject>Intraoperative Complications - diagnosis</subject><subject>Intraoperative Complications - surgery</subject><subject>Laryngoscopy - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Phonation - physiology</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Recurrent Laryngeal Nerve Injuries - etiology</subject><subject>Recurrent Laryngeal Nerve Injuries - surgery</subject><subject>Retrospective Studies</subject><subject>Speech disorders</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Thyroidectomy - adverse effects</subject><subject>Thyroidectomy - methods</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Voice Quality</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1vFCEYgInR2LV68QcYEi_GZCovHzNwbBqtJhsbTU3VC2GHd1vWmaECY91_L-u2PXjwRALP-wAPIc-BHQFj_M3g0vaIS6nYA7IAJaCRxqiHZFEPRaMV_3pAnuS8YQw6odhjcsAlgGxbsyD-bC59HJHehHJFwziiD64g9SFhX6ibXC5xjDlkGte07s0p4VTo7s7pEt1AJ0y_MNMwbeaEnvo5hemSlqttisFXRxy3T8mjtRsyPrtdD8mXd2_PT943y7PTDyfHy6YXRrHGCc6kUOB4b4R0PQBH3bGeMQ-CdSupjZTcoJZKagCNslvptfaotPemB3FIXu291yn-nDEXO4bc4zC4CeOcbW3DBBjeyoq-_AfdxDlN9XWV4loBZ8ZU6vWe6lPMOeHaXqcw1q9bYHbX3u462L_tK_ziVjmvasZ79C52BWAP3IQBt_9R2eXx52930mY_E3LB3_czLv2wbSc6ZS8-nlowum0vPn235-IPO5OeOA</recordid><startdate>201406</startdate><enddate>201406</enddate><creator>Hong, Jong W.</creator><creator>Roh, Tai S.</creator><creator>Yoo, Han-Su</creator><creator>Hong, Hyun J.</creator><creator>Choi, Hong-Shik</creator><creator>Chang, Hang S.</creator><creator>Park, Cheong S.</creator><creator>Kim, Young S.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201406</creationdate><title>Outcome with immediate direct anastomosis of recurrent laryngeal nerves injured during thyroidectomy</title><author>Hong, Jong W. ; Roh, Tai S. ; Yoo, Han-Su ; Hong, Hyun J. ; Choi, Hong-Shik ; Chang, Hang S. ; Park, Cheong S. ; Kim, Young S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3950-a3204351a2c934ac112e870c00d1307b4894429e84548118e47b8f8de58dd9c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anastomosis, Surgical - methods</topic><topic>Carcinoma, Papillary - pathology</topic><topic>Carcinoma, Papillary - surgery</topic><topic>Cohort Studies</topic><topic>direct nerve anastomosis</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Iatrogenic Disease</topic><topic>immediate nerve anastomosis</topic><topic>Injured recurrent laryngeal nerve</topic><topic>Intraoperative Complications - diagnosis</topic><topic>Intraoperative Complications - surgery</topic><topic>Laryngoscopy - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Phonation - physiology</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Recurrent Laryngeal Nerve Injuries - etiology</topic><topic>Recurrent Laryngeal Nerve Injuries - surgery</topic><topic>Retrospective Studies</topic><topic>Speech disorders</topic><topic>Thyroid Neoplasms - pathology</topic><topic>Thyroid Neoplasms - surgery</topic><topic>Thyroidectomy - adverse effects</topic><topic>Thyroidectomy - methods</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Voice Quality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hong, Jong W.</creatorcontrib><creatorcontrib>Roh, Tai S.</creatorcontrib><creatorcontrib>Yoo, Han-Su</creatorcontrib><creatorcontrib>Hong, Hyun J.</creatorcontrib><creatorcontrib>Choi, Hong-Shik</creatorcontrib><creatorcontrib>Chang, Hang S.</creatorcontrib><creatorcontrib>Park, Cheong S.</creatorcontrib><creatorcontrib>Kim, Young S.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hong, Jong W.</au><au>Roh, Tai S.</au><au>Yoo, Han-Su</au><au>Hong, Hyun J.</au><au>Choi, Hong-Shik</au><au>Chang, Hang S.</au><au>Park, Cheong S.</au><au>Kim, Young S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome with immediate direct anastomosis of recurrent laryngeal nerves injured during thyroidectomy</atitle><jtitle>The Laryngoscope</jtitle><addtitle>The Laryngoscope</addtitle><date>2014-06</date><risdate>2014</risdate><volume>124</volume><issue>6</issue><spage>1402</spage><epage>1408</epage><pages>1402-1408</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis
Management of unrecognized recurrent laryngeal nerve injury typically entails delayed phonosurgical intervention and laryngeal reinnervation, but in cases of recognized injury, nerve anastomosis has been considered standard management. However, the well‐organized outcome analysis of nerve anastomosis has been insufficient. We performed immediate direct anastomosis of recurrent laryngeal nerves injured during surgery for thyroid cancer, and subsequent patient outcomes were analyzed.
Study Design
A total 14 patients sustaining recurrent laryngeal nerve injury during thyroidectomy were recruited for the study. Patients undergoing immediate direct reparative anastomosis of the injured nerves constituted the test group, whereas the controls of group 2 (n = 4) did not.
Methods
At follow‐up, all patients submitted to rigid laryngoscopy at 3, 6, and 12 months postoperatively. Subjective and objective outcomes of the two groups were then compared.
Results
At 12 months postoperatively, group 1 showed greater improvement in maximum phonation time, glottic gap scores, GRBAS (grade, roughness, breathiness, asthenia, and strain) scales, aspiration scoring, and Voice Handicap Index than controls of group 2. Moreover, group 1 showed an improvement in all five categories at 12 months postoperatively, compared with status at 3 months. None of the patients in group 1 showed laryngoscopic evidence of vocal cord atrophy.
Conclusion
In this study, patients undergoing immediate direct recurrent laryngeal nerve anastomosis demonstrated better phonation and perceptually rated voice quality than those who did not undergo repair.
Level of Evidence
3b. Laryngoscope, 124:1402–1408, 2014</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>24114669</pmid><doi>10.1002/lary.24450</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Anastomosis, Surgical - methods Carcinoma, Papillary - pathology Carcinoma, Papillary - surgery Cohort Studies direct nerve anastomosis Female Follow-Up Studies Humans Iatrogenic Disease immediate nerve anastomosis Injured recurrent laryngeal nerve Intraoperative Complications - diagnosis Intraoperative Complications - surgery Laryngoscopy - methods Male Middle Aged Phonation - physiology Reconstructive Surgical Procedures - methods Recurrent Laryngeal Nerve Injuries - etiology Recurrent Laryngeal Nerve Injuries - surgery Retrospective Studies Speech disorders Thyroid Neoplasms - pathology Thyroid Neoplasms - surgery Thyroidectomy - adverse effects Thyroidectomy - methods Time Factors Treatment Outcome Voice Quality |
| title | Outcome with immediate direct anastomosis of recurrent laryngeal nerves injured during thyroidectomy |
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