BACKGROUND: The aim of this study was to assess the impact of the neuromonitoring of the external branch of the superior laryngeal nerve (EBSLN) on the voice quality after mini-incision thyroidectomy under local/regional anesthesia and intravenous sedation. METHODS:Patients undergoing mini-incision thyroidectomy under local anesthesia were prospectively randomized for either nerve monitoring of the EBSLN (group 1) or no nerve monitoring (group 2). Voice and swallowing assessment were obtained by using the Voice Handicap Index-10 (VHI-10) and the Reflux Symptom Index questionnaires (RSI) before surgery and at 3 weeks and 3 months after surgery. RESULTS: Recruitment led to 22 patients in group 1 and 25 patients in group 2. The rate of visualized EBSLN was higher in group 1 (66% vs 21%; P = .003). Contrary to group 1, in group 2, the median total VHI-10 score was significantly higher 3 months after surgery (P = .034) compared with preoperatively, indicating a subjective voice handicap. In both groups, there was no difference in median total RSI score before surgery or at 3 weeks and 3 months after surgery. CONCLUSION: Nerve monitoring aids in the visualization of the EBSLN during mini-incision thyroidectomy under local/regional anesthesia and leads to an improvement in patient-assessed voice quality after surgery but does not impact swallowing.
RCT Entities:
BACKGROUND: The aim of this study was to assess the impact of the neuromonitoring of the external branch of the superior laryngeal nerve (EBSLN) on the voice quality after mini-incision thyroidectomy under local/regional anesthesia and intravenous sedation. METHODS:Patients undergoing mini-incision thyroidectomy under local anesthesia were prospectively randomized for either nerve monitoring of the EBSLN (group 1) or no nerve monitoring (group 2). Voice and swallowing assessment were obtained by using the Voice Handicap Index-10 (VHI-10) and the Reflux Symptom Index questionnaires (RSI) before surgery and at 3 weeks and 3 months after surgery. RESULTS: Recruitment led to 22 patients in group 1 and 25 patients in group 2. The rate of visualized EBSLN was higher in group 1 (66% vs 21%; P = .003). Contrary to group 1, in group 2, the median total VHI-10 score was significantly higher 3 months after surgery (P = .034) compared with preoperatively, indicating a subjective voice handicap. In both groups, there was no difference in median total RSI score before surgery or at 3 weeks and 3 months after surgery. CONCLUSION: Nerve monitoring aids in the visualization of the EBSLN during mini-incision thyroidectomy under local/regional anesthesia and leads to an improvement in patient-assessed voice quality after surgery but does not impact swallowing.
Authors: Andre S Potenza; Eimear A Phelan; Claudio R Cernea; Cristian M Slough; Dipti V Kamani; Ashlie Darr; David Zurakowski; Gregory W Randolph Journal: World J Surg Date: 2013-10 Impact factor: 3.352
Authors: Su-Jin Kim; Kyu Eun Lee; Byung-Mo Oh; Eun Mee Oh; Dong Sik Bae; June Young Choi; Jun Pyo Myong; Yeo-Kyu Youn Journal: Ann Surg Treat Res Date: 2015-10-28 Impact factor: 1.859
Authors: Alvaro Sanabria; Adonis Ramirez; Luiz P Kowalski; Carl E Silver; Ashok R Shaha; Randall P Owen; Carlos Suárez; Avi Khafif; Alessandra Rinaldo; Alfio Ferlito Journal: Eur Arch Otorhinolaryngol Date: 2013-05-17 Impact factor: 2.503