Vijay Naraynsingh1, Shamir O Cawich2, Ravi Maharaj1, Dilip Dan1. 1. Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad and Tobago. 2. Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad and Tobago. Electronic address: socawich@hotmail.com.
Abstract
INTRODUCTION: The external branch of the superior laryngeal nerve (EBSLN) should be identified during thyroidectomy to prevent injury and post-operative voice change. Identification is rendered difficult during a standard thyroidectomy where there is a large gland with upper pole enlargement. We describe the retrograde thyroidectomy technique to facilitate nerve preservation. PRESENTATION OF CASE: A retrograde thyroidectomy was performed in a 53-year old woman with a difficult goiter. Operative steps are described. DISCUSSION: This technique allows the upper pole to be completely mobilized caudally providing unparalleled visualization of the upper pole vascular pedicle, thereby preserving the EBSLN. CONCLUSION: There is better visualization of the superior thyroid pedicle and the EBSLN with retrograde thyroidectomy, potentially reducing the incidence of EBSLN injury during a difficult thyroidectomy.
INTRODUCTION: The external branch of the superior laryngeal nerve (EBSLN) should be identified during thyroidectomy to prevent injury and post-operative voice change. Identification is rendered difficult during a standard thyroidectomy where there is a large gland with upper pole enlargement. We describe the retrograde thyroidectomy technique to facilitate nerve preservation. PRESENTATION OF CASE: A retrograde thyroidectomy was performed in a 53-year old woman with a difficult goiter. Operative steps are described. DISCUSSION: This technique allows the upper pole to be completely mobilized caudally providing unparalleled visualization of the upper pole vascular pedicle, thereby preserving the EBSLN. CONCLUSION: There is better visualization of the superior thyroid pedicle and the EBSLN with retrograde thyroidectomy, potentially reducing the incidence of EBSLN injury during a difficult thyroidectomy.