Intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgery

Abstract The most common surgical risk after total thyroidectomy remains the recurrent laryngeal nerve (RLN) injury. Nowadays, the use of intraoperative nerve monitoring systems (IONM) such as the endotracheal tube‐based is recommended to prevent RLN palsy. The use of the nerve monitoring is standar...

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Main Authors: Carta Filippo, Marrosu Valeria, Pinto Valeria, Tatti Melania, Mauro Bontempi, Mariani Cinzia, Puxeddu Roberto
Format: Article
Language:English
Published: Wiley 2022-07-01
Series:Clinical Case Reports
Subjects:
Online Access:https://doi.org/10.1002/ccr3.6137
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author Carta Filippo
Marrosu Valeria
Pinto Valeria
Tatti Melania
Mauro Bontempi
Mariani Cinzia
Puxeddu Roberto
author_facet Carta Filippo
Marrosu Valeria
Pinto Valeria
Tatti Melania
Mauro Bontempi
Mariani Cinzia
Puxeddu Roberto
author_sort Carta Filippo
collection DOAJ
description Abstract The most common surgical risk after total thyroidectomy remains the recurrent laryngeal nerve (RLN) injury. Nowadays, the use of intraoperative nerve monitoring systems (IONM) such as the endotracheal tube‐based is recommended to prevent RLN palsy. The use of the nerve monitoring is standardized by dedicated guidelines on the basis of a normal laryngeal anatomy, but previous head and neck surgical procedures may complicate its application. The authors herewith present a case of a non‐conventional use of endotracheal tube‐based IONM in a 72‐year‐old patient who underwent to a second‐stage total thyroidectomy for metastatic papillary cancer incidentally detected after an open partial horizontal laryngectomy (OPHL) extended to one arytenoid (Type IIa + ary left) for squamous cell carcinoma. The use of the endotracheal tube‐based IONM in such particular case where the function of the only remaining arytenoid had to be absolutely preserved was effective in avoiding the RLN accidental injury. The authors reviewed the non‐traditional use of IONM and described the procedure in case of thyroidectomy in patients previously treated by OPHL.
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spelling doaj.art-ce34abaccc334688bdaaa710ac4ef9a42022-12-22T01:56:09ZengWileyClinical Case Reports2050-09042022-07-01107n/an/a10.1002/ccr3.6137Intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgeryCarta Filippo0Marrosu Valeria1Pinto Valeria2Tatti Melania3Mauro Bontempi4Mariani Cinzia5Puxeddu Roberto6Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero‐Universitaria di Cagliari University of Cagliari Cagliari ItalyUnit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero‐Universitaria di Cagliari University of Cagliari Cagliari ItalyUnit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero‐Universitaria di Cagliari University of Cagliari Cagliari ItalyUnit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero‐Universitaria di Cagliari University of Cagliari Cagliari ItalyUnit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero‐Universitaria di Cagliari University of Cagliari Cagliari ItalyUnit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero‐Universitaria di Cagliari University of Cagliari Cagliari ItalyUnit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero‐Universitaria di Cagliari University of Cagliari Cagliari ItalyAbstract The most common surgical risk after total thyroidectomy remains the recurrent laryngeal nerve (RLN) injury. Nowadays, the use of intraoperative nerve monitoring systems (IONM) such as the endotracheal tube‐based is recommended to prevent RLN palsy. The use of the nerve monitoring is standardized by dedicated guidelines on the basis of a normal laryngeal anatomy, but previous head and neck surgical procedures may complicate its application. The authors herewith present a case of a non‐conventional use of endotracheal tube‐based IONM in a 72‐year‐old patient who underwent to a second‐stage total thyroidectomy for metastatic papillary cancer incidentally detected after an open partial horizontal laryngectomy (OPHL) extended to one arytenoid (Type IIa + ary left) for squamous cell carcinoma. The use of the endotracheal tube‐based IONM in such particular case where the function of the only remaining arytenoid had to be absolutely preserved was effective in avoiding the RLN accidental injury. The authors reviewed the non‐traditional use of IONM and described the procedure in case of thyroidectomy in patients previously treated by OPHL.https://doi.org/10.1002/ccr3.6137intraoperative nerve monitoringmetastatic papillary cancerOPHLpartial laryngectomythyroid cancer
spellingShingle Carta Filippo
Marrosu Valeria
Pinto Valeria
Tatti Melania
Mauro Bontempi
Mariani Cinzia
Puxeddu Roberto
Intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgery
Clinical Case Reports
intraoperative nerve monitoring
metastatic papillary cancer
OPHL
partial laryngectomy
thyroid cancer
title Intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgery
title_full Intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgery
title_fullStr Intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgery
title_full_unstemmed Intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgery
title_short Intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgery
title_sort intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgery
topic intraoperative nerve monitoring
metastatic papillary cancer
OPHL
partial laryngectomy
thyroid cancer
url https://doi.org/10.1002/ccr3.6137
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AT tattimelania intraoperativerecurrentlaryngealnervemonitoringinunconventionalthyroidsurgery
AT maurobontempi intraoperativerecurrentlaryngealnervemonitoringinunconventionalthyroidsurgery
AT marianicinzia intraoperativerecurrentlaryngealnervemonitoringinunconventionalthyroidsurgery
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