H J Neumann1. 1. Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie Städtisches Krankenhaus Martha-Maria Halle-Dölau gGmbH, Akademisches Lehrkrankenhaus, Medizinischen Fakultät, Martin-Luther-Universität Halle-Wittenberg. 03455590-0007@t-online.de
Abstract
BACKGROUND: Frequently numerous recurrent laryngeal nerve injuries occur after operations on the thyroid glands. Compared with postoperative permanent hypocalcemia, unilateral and especially double-side recurrent paresis pose serious complication. As early as 1938 specialists [1] pleaded for a routine visualisation of the nervus recurrens in operations of the thyroid gland, to reduce the risk of permanently recurring paresis. In controversial discussions of the matter specialists have opted for a demonstration of the nerve also under medico-legal aspects. Implementing functionally-critical operational strategies requires the choice of an anatomically suitable operative procedure for the removal of morphological, functional and oncological changes, as well as the avoidance of complications. METHOD: Intra-operative Monitoring is highly recommendable as a neurophysiological method of supervision combined with microdissection to ensure the safe handling of recurrent laryngeal nerve. CONCLUSION: The rate of permanent paresis on the recurrent nerve can be lowered to less than 1 per cent when this is used as a routine procedure for all operations and the treatment of the thyroid gland diseases.
BACKGROUND: Frequently numerous recurrent laryngeal nerve injuries occur after operations on the thyroid glands. Compared with postoperative permanent hypocalcemia, unilateral and especially double-side recurrent paresis pose serious complication. As early as 1938 specialists [1] pleaded for a routine visualisation of the nervus recurrens in operations of the thyroid gland, to reduce the risk of permanently recurring paresis. In controversial discussions of the matter specialists have opted for a demonstration of the nerve also under medico-legal aspects. Implementing functionally-critical operational strategies requires the choice of an anatomically suitable operative procedure for the removal of morphological, functional and oncological changes, as well as the avoidance of complications. METHOD: Intra-operative Monitoring is highly recommendable as a neurophysiological method of supervision combined with microdissection to ensure the safe handling of recurrent laryngeal nerve. CONCLUSION: The rate of permanent paresis on the recurrent nerve can be lowered to less than 1 per cent when this is used as a routine procedure for all operations and the treatment of the thyroid gland diseases.
Authors: W Timmermann; W H Hamelmann; O Thomusch; C Sekulla; S Grond; H J Neumann; E Kruse; H P Mühlig; C Richter; J Voss; H Dralle Journal: Chirurg Date: 2004-09 Impact factor: 0.955
Authors: H Dralle; K Lorenz; P Schabram; T J Musholt; C Dotzenrath; P E Goretzki; J Kußmann; B Niederle; C Nies; J Schabram; C Scheuba; D Simon; T Steinmüller; A Trupka Journal: Chirurg Date: 2013-12 Impact factor: 0.955
Authors: J M Prades; M D Dubois; J M Dumollard; L Tordella; J Rigail; A P Timoshenko; M Peoc'h Journal: Surg Radiol Anat Date: 2012-07-11 Impact factor: 1.246