Mehmet Uludag1, Gurkan Yetkin2, Ebru S Oran2, Nurcihan Aygun2, Fevzi Celayir2, Abdulcabbar Kartal2, Adnan Isgor3. 1. , Atakent Mahallesi. 3. Etap. Manolya çıkmazı. No: 2E/1 Blok: D21/1 Daire:1, Kucukcekmece, 34303, Istanbul, Turkey. drmuludag@hotmail.com. 2. Department of General Surgery, Sisli Etfal Training and Research Hospital, Halaskargazi caddesi Etfal sokak. Sisli, 34820, Istanbul, Turkey. 3. Department of General Surgery, Bahcesehir University Medical Faculty, Goztepe, Istanbul, Turkey.
Abstract
INTRODUCTION: Our aim was to evaluate the findings of intraoperative nerve monitoring (IONM) in two cases with preoperative vocal cord palsy. Case 1: a 61-year-old female with recurrent goiter underwent secondary thyroidectomy. The preoperative evaluation of the vocal cords revealed right vocal cord paralyses without atrophy. The right recurrent laryngeal nerve (RLN) was found to be anatomically intact and preserved. The electrical responses of the vocal cords were elicited via IONM. Case 2: a 26-year-old male, who presented with preoperative right vocal cord palsy with atrophy, underwent completion thyroidectomy secondary to papillary carcinoma. The right RLN was explored and found to be tied and interrupted. There was no signal from the RLN with IONM. CONCLUSION: Even in cases with vocal cord palsy detected preoperatively, the nerve should be explored intraoperatively, and should never be sacrificed before an evaluation by nerve monitoring. A palsied RLN which has electrical activity should be protected to maintain the vocal cord's neural tone and to prevent its atrophy.
INTRODUCTION: Our aim was to evaluate the findings of intraoperative nerve monitoring (IONM) in two cases with preoperative vocal cord palsy. Case 1: a 61-year-old female with recurrent goiter underwent secondary thyroidectomy. The preoperative evaluation of the vocal cords revealed right vocal cord paralyses without atrophy. The right recurrent laryngeal nerve (RLN) was found to be anatomically intact and preserved. The electrical responses of the vocal cords were elicited via IONM. Case 2: a 26-year-old male, who presented with preoperative right vocal cord palsy with atrophy, underwent completion thyroidectomy secondary to papillary carcinoma. The right RLN was explored and found to be tied and interrupted. There was no signal from the RLN with IONM. CONCLUSION: Even in cases with vocal cord palsy detected preoperatively, the nerve should be explored intraoperatively, and should never be sacrificed before an evaluation by nerve monitoring. A palsied RLN which has electrical activity should be protected to maintain the vocal cord's neural tone and to prevent its atrophy.
Authors: A Bergenfelz; S Jansson; A Kristoffersson; H Mårtensson; E Reihnér; G Wallin; I Lausen Journal: Langenbecks Arch Surg Date: 2008-07-17 Impact factor: 3.445