Su-Jin Kim1, Kyu Eun Lee1, Byung-Mo Oh2, Eun Mee Oh1, Dong Sik Bae3, June Young Choi4, Jun Pyo Myong5, Yeo-Kyu Youn1. 1. Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. 2. Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. 3. Department of Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea. 4. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea. 5. Department of Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, The Catholic University College of Medicine, Seoul, Korea.
Abstract
PURPOSE: The aim of this study was to evaluate the feasibility of monitoring external branch of the superior laryngeal nerve (EBSLN) during robotic thyroid surgery. METHODS: A total of 10 patients undergoing bilateral axillo-breast approach (BABA) robotic thyroid surgery were enrolled. The nerve integrity monitor (NIM Response 2.0 System) was used for EBSLN monitoring. We performed voice assessments preoperatively and at 1 and 3 months postoperatively using Voice Handicap Index-10 (VHI-10), maximal phonation time (MPT), phonation efficient index (PEI), and laryngeal electromyography (EMG). RESULTS: A total of 19 EBSLNs were at risk and 14 EBSLNs (73.7%) were identified using neuromonitoring. VHI-10 showed a change of voice over time (0.1 vs. 3.6 vs. 1.3); however, this was not statistically significant. VHI-10 scores normalized at 3 months postoperatively compared to the preoperative scores. MPT (a) (16.0 vs. 15.6 vs. 15.4), and MPT (e) (20.1 vs. 15.4 vs. 18.5) showed no significant differences preoperatively compared to the values obtained 1 and 3 months postoperatively. There was a significant change of PEI over time (4.8 vs. 1.1 vs. 4.6) (P = 0.036); however, the values normalized at 3 months postoperatively. Laryngeal EMG results showed 4 cases (21.2%) of neuropathy of EBSLNs at 1 month postoperatively, and electrodiagnostic studies revealed nearly complete recovery of the function of EBSLNs in 4 patients at 3 months postoperatively. CONCLUSION: It is suggested that neuromonitoring of EBSLNs during BABA robotic thyroid surgery is feasible and might be helpful to preserve voice quality.
PURPOSE: The aim of this study was to evaluate the feasibility of monitoring external branch of the superior laryngeal nerve (EBSLN) during robotic thyroid surgery. METHODS: A total of 10 patients undergoing bilateral axillo-breast approach (BABA) robotic thyroid surgery were enrolled. The nerve integrity monitor (NIM Response 2.0 System) was used for EBSLN monitoring. We performed voice assessments preoperatively and at 1 and 3 months postoperatively using Voice Handicap Index-10 (VHI-10), maximal phonation time (MPT), phonation efficient index (PEI), and laryngeal electromyography (EMG). RESULTS: A total of 19 EBSLNs were at risk and 14 EBSLNs (73.7%) were identified using neuromonitoring. VHI-10 showed a change of voice over time (0.1 vs. 3.6 vs. 1.3); however, this was not statistically significant. VHI-10 scores normalized at 3 months postoperatively compared to the preoperative scores. MPT (a) (16.0 vs. 15.6 vs. 15.4), and MPT (e) (20.1 vs. 15.4 vs. 18.5) showed no significant differences preoperatively compared to the values obtained 1 and 3 months postoperatively. There was a significant change of PEI over time (4.8 vs. 1.1 vs. 4.6) (P = 0.036); however, the values normalized at 3 months postoperatively. Laryngeal EMG results showed 4 cases (21.2%) of neuropathy of EBSLNs at 1 month postoperatively, and electrodiagnostic studies revealed nearly complete recovery of the function of EBSLNs in 4 patients at 3 months postoperatively. CONCLUSION: It is suggested that neuromonitoring of EBSLNs during BABA robotic thyroid surgery is feasible and might be helpful to preserve voice quality.
Authors: C R Cernea; A R Ferraz; J Furlani; S Monteiro; S Nishio; F C Hojaij; A Dutra Júnior; L A Marques; P A Pontes; R G Bevilacqua Journal: Am J Surg Date: 1992-12 Impact factor: 2.565
Authors: Beata Wojtczak; Krzysztof Sutkowski; Krzysztof Kaliszewski; Zdzisław Forkasiewicz; Bartłomiej Knychalski; Michał Aporowicz; Marek Bolanowski; Marcin Barczyński Journal: Endocrine Date: 2018-05-05 Impact factor: 3.633
Authors: Barbara Martino; Letizia Nitro; Loredana De Pasquale; Paolo Lozza; Alberto Maccari; Luca Castellani; Matilde Piazzoni; Matteo Cardellicchio; Antonio Mario Bulfamante; Carlotta Pipolo; Giovanni Felisati; Alberto Maria Saibene Journal: Int J Med Robot Date: 2022-06-05 Impact factor: 2.483