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• W2410881409 abstract "The close proximity of the recurrent laryngeal nerves (RLN) to the thyroid gland places the nerve at risk of injury during thyroid surgery. Furthermore, thyroid surgery can put both the right and the left RLNs at risk during a single surgical procedure. RLN injury or invasion by cancer can cause vocal cord paralysis (VCP) that leads to substantial morbidity arising from voice, swallowing and breathing issues. Unilateral VCP can lead to voice changes that may greatly impact professional voice users, as well as can cause potential dysphagia and aspiration, whereas bilateral VCP may require tracheostomy. Along with excellent anatomical understanding, intraoperative neural monitoring (IONM) can help in nerve mapping and identification. Additionally, IONM can help predict neural injury as well as play a role in management of invaded nerve and surgical decision-making. Several general surgical principles should be closely followed to protect RLNs during thyroid surgery. Based on the pathology and indication for surgery, different surgical approaches to the RLN: lateral, superior or inferior, can be used. Following standards of IONM and a good understanding of normative IONM characteristics for RLN are essential for accurate monitoring and proper interpretation of IONM data during a thyroid surgery. With the increasing use of IONM and given its value in intraoperative surgical management, it is important that the surgeon has a preoperative discussion with the patient regarding the use and implications of IONM on intraoperative surgical decision-making." @default.
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• W2410881409 date "1952-08-01" @default.
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• W2410881409 title "Anatomy of the Endocrine Glands" @default.
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• W2410881409 doi "https://doi.org/10.1016/s0039-6109(16)33694-5" @default.
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