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Deepak Awasthi - One of the best experts on this subject based on the ideXlab platform.
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Anatomic considerations of superior Laryngeal Nerve during anterior cervical spine procedures.
Spine, 2002Co-Authors: Hooman Melamed, Mitchel B. Harris, Deepak AwasthiAbstract:Cadavers were dissected anatomically to identify the course of the superior Laryngeal Nerve relative to the spinal column. To illustrate the anatomic relation of the SLN with respect to its vulnerability during anterior cervical spine procedures. There is ample literature referencing the superior Laryngeal Nerve with respect to head and neck surgery. Detailed descriptions of the anatomy of the recurrent Laryngeal Nerve are quite extensive in both the spine and head and neck literature. To the authors' best knowledge, no similar reports have delineated the anatomic relation of the superior Laryngeal Nerve in procedures on the anterior aspect of the cervical spine. Ten dissections were carried out on human cadavers to show the course of the superior Laryngeal Nerve. Particular attention was directed to the internal branch of the superior Laryngeal Nerve to show the overall anatomic relation relative to standard landmarks. These landmarks included the superior Laryngeal and superior thyroid arteries, the split of the superior Laryngeal Nerve, and the intervertebral disc space. The superior Laryngeal Nerve originates from the vagus Nerve in the carotid sheath and bifurcates into internal and external branches. Distally, the internal branch of the superior Laryngeal Nerve courses in close proximity with the superior Laryngeal artery and inserts within 1 cm superior to the superior Laryngeal artery into the thyrohyoid membrane. With respect to the cervical spine, the distal of portion of the internal branch of the superior Laryngeal Nerve is located between the C3 and C4 vertebral bodies. The internal branch of the superior Laryngeal Nerve supplies innervation to the mucosa of the larynx and has an important sensory reflex that serves to protect the lungs from aspiration. Injury to this Nerve can predispose the patient to life-threatening pneumonia. It is therefore imperative for the surgeon to recognize the location and course of this Nerve to avoid injuring it. Injury most commonly occurs either by excessive retraction in different planes or by accidental ligation of the Nerve.
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anatomic considerations of superior Laryngeal Nerve during anterior cervical spine procedures
Spine, 2002Co-Authors: Hooman Melamed, Mitchel B. Harris, Deepak AwasthiAbstract:STUDY DESIGN Cadavers were dissected anatomically to identify the course of the superior Laryngeal Nerve relative to the spinal column. OBJECTIVE To illustrate the anatomic relation of the SLN with respect to its vulnerability during anterior cervical spine procedures. SUMMARY OF BACKGROUND DATA There is ample literature referencing the superior Laryngeal Nerve with respect to head and neck surgery. Detailed descriptions of the anatomy of the recurrent Laryngeal Nerve are quite extensive in both the spine and head and neck literature. To the authors' best knowledge, no similar reports have delineated the anatomic relation of the superior Laryngeal Nerve in procedures on the anterior aspect of the cervical spine. METHODS Ten dissections were carried out on human cadavers to show the course of the superior Laryngeal Nerve. Particular attention was directed to the internal branch of the superior Laryngeal Nerve to show the overall anatomic relation relative to standard landmarks. These landmarks included the superior Laryngeal and superior thyroid arteries, the split of the superior Laryngeal Nerve, and the intervertebral disc space. RESULTS The superior Laryngeal Nerve originates from the vagus Nerve in the carotid sheath and bifurcates into internal and external branches. Distally, the internal branch of the superior Laryngeal Nerve courses in close proximity with the superior Laryngeal artery and inserts within 1 cm superior to the superior Laryngeal artery into the thyrohyoid membrane. With respect to the cervical spine, the distal of portion of the internal branch of the superior Laryngeal Nerve is located between the C3 and C4 vertebral bodies. CONCLUSIONS The internal branch of the superior Laryngeal Nerve supplies innervation to the mucosa of the larynx and has an important sensory reflex that serves to protect the lungs from aspiration. Injury to this Nerve can predispose the patient to life-threatening pneumonia. It is therefore imperative for the surgeon to recognize the location and course of this Nerve to avoid injuring it. Injury most commonly occurs either by excessive retraction in different planes or by accidental ligation of the Nerve.
Barry L. Wenig - One of the best experts on this subject based on the ideXlab platform.
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Superior Laryngeal Nerve injury from thyroid surgery
Head & neck, 1995Co-Authors: Benjamin J. Teitelbaum, Barry L. WenigAbstract:Injury to the recurrent Laryngeal Nerve is a well-recognized complication of thyroid surgery. Injury to the superior Laryngeal Nerve is less documented, perhaps due to the difficulty in recognizing its manifestations. This study was designed to document the incidence of injury to the superior Laryngeal Nerve in a series of patients who underwent thyroidectomy. Twenty consecutive patients with thyroidectomy during a 9-month period underwent evaluation for superior Laryngeal Nerve injury 3 months postoperatively. Methods for evaluation included Laryngeal videostroboscopy, Laryngeal electromyography, and a subjective interview. One patient (5%) was diagnosed with unilateral superior Laryngeal Nerve injury. The risk of injury to the superior Laryngeal Nerve during thyroidectomy is significant, and the result may be devastating to those patients who rely on their voices professionally. Laryngeal videostroboscopy and electromyography may be necessary to diagnose superior Laryngeal Nerve injury.
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superior Laryngeal Nerve injury from thyroid surgery
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 1995Co-Authors: Benjamin J. Teitelbaum, Barry L. WenigAbstract:Background. Injury to the recurrent Laryngeal Nerve is a well-recognized complication of thyroid surgery. Injury to the superior Laryngeal Nerve is less documented, perhaps due to the difficulty in recognizing its manifestations. This study was designed to document the incidence of injury to the superior Laryngeal Nerve in a series of patients who underwent thyroidectomy. Methods. Twenty consecutive patients with thyroidectomy during a 9-month period underwent evaluation for superior Laryngeal Nerve injury 3 months postoperatively. Methods for evaluation included Laryngeal videostroboscopy, Laryngeal electromyography, and a subjective interview. Results. One patient (5%) was diagnosed with unilateral superior Laryngeal Nerve injury. Conclusions. The risk of injury to the superior Laryngeal Nerve during thyroidectomy is significant, and the result may be devastating to those patients who rely on their voices professionally. Laryngeal videostroboscopy and electromyography may be necessary to diagnose superior Laryngeal Nerve injury. © 1995 Jons Wiley & Sons, Inc.
Natasha Mirza - One of the best experts on this subject based on the ideXlab platform.
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Trauma‐induced schwannoma of the recurrent Laryngeal Nerve after thyroidectomy
Laryngoscope, 2015Co-Authors: William P. Kennedy, Amber R. Wang, Robert M Brody, Virginia A. Livolsi, Natasha MirzaAbstract:Laryngeal schwannomas are rare, benign tumors, most often arising from the superior Laryngeal Nerve. We describe a case of a 68-year-old female with a Laryngeal schwannoma of the recurrent Laryngeal Nerve after traumatic injury. We postulate that trauma to the recurrent Laryngeal Nerve during thyroidectomy or thyroplasty incited growth of a Nerve sheath tumor. This is the first reported case of a trauma-induced schwannoma of the recurrent Laryngeal Nerve and second case of a recurrent Laryngeal Nerve schwannoma. Although rare, this case demonstrates that these tumors should be considered during workup of vocal cord paresis after surgery or failed thyroplasty. Laryngoscope, 126:1408-1410, 2016.
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Trauma-induced schwannoma of the recurrent Laryngeal Nerve after thyroidectomy.
The Laryngoscope, 2015Co-Authors: William P. Kennedy, Amber R. Wang, Robert M Brody, Virginia A. Livolsi, Natasha MirzaAbstract:Laryngeal schwannomas are rare, benign tumors, most often arising from the superior Laryngeal Nerve. We describe a case of a 68-year-old female with a Laryngeal schwannoma of the recurrent Laryngeal Nerve after traumatic injury. We postulate that trauma to the recurrent Laryngeal Nerve during thyroidectomy or thyroplasty incited growth of a Nerve sheath tumor. This is the first reported case of a trauma-induced schwannoma of the recurrent Laryngeal Nerve and second case of a recurrent Laryngeal Nerve schwannoma. Although rare, this case demonstrates that these tumors should be considered during workup of vocal cord paresis after surgery or failed thyroplasty. Laryngoscope, 126:1408-1410, 2016.
Hooman Melamed - One of the best experts on this subject based on the ideXlab platform.
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Anatomic considerations of superior Laryngeal Nerve during anterior cervical spine procedures.
Spine, 2002Co-Authors: Hooman Melamed, Mitchel B. Harris, Deepak AwasthiAbstract:Cadavers were dissected anatomically to identify the course of the superior Laryngeal Nerve relative to the spinal column. To illustrate the anatomic relation of the SLN with respect to its vulnerability during anterior cervical spine procedures. There is ample literature referencing the superior Laryngeal Nerve with respect to head and neck surgery. Detailed descriptions of the anatomy of the recurrent Laryngeal Nerve are quite extensive in both the spine and head and neck literature. To the authors' best knowledge, no similar reports have delineated the anatomic relation of the superior Laryngeal Nerve in procedures on the anterior aspect of the cervical spine. Ten dissections were carried out on human cadavers to show the course of the superior Laryngeal Nerve. Particular attention was directed to the internal branch of the superior Laryngeal Nerve to show the overall anatomic relation relative to standard landmarks. These landmarks included the superior Laryngeal and superior thyroid arteries, the split of the superior Laryngeal Nerve, and the intervertebral disc space. The superior Laryngeal Nerve originates from the vagus Nerve in the carotid sheath and bifurcates into internal and external branches. Distally, the internal branch of the superior Laryngeal Nerve courses in close proximity with the superior Laryngeal artery and inserts within 1 cm superior to the superior Laryngeal artery into the thyrohyoid membrane. With respect to the cervical spine, the distal of portion of the internal branch of the superior Laryngeal Nerve is located between the C3 and C4 vertebral bodies. The internal branch of the superior Laryngeal Nerve supplies innervation to the mucosa of the larynx and has an important sensory reflex that serves to protect the lungs from aspiration. Injury to this Nerve can predispose the patient to life-threatening pneumonia. It is therefore imperative for the surgeon to recognize the location and course of this Nerve to avoid injuring it. Injury most commonly occurs either by excessive retraction in different planes or by accidental ligation of the Nerve.
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anatomic considerations of superior Laryngeal Nerve during anterior cervical spine procedures
Spine, 2002Co-Authors: Hooman Melamed, Mitchel B. Harris, Deepak AwasthiAbstract:STUDY DESIGN Cadavers were dissected anatomically to identify the course of the superior Laryngeal Nerve relative to the spinal column. OBJECTIVE To illustrate the anatomic relation of the SLN with respect to its vulnerability during anterior cervical spine procedures. SUMMARY OF BACKGROUND DATA There is ample literature referencing the superior Laryngeal Nerve with respect to head and neck surgery. Detailed descriptions of the anatomy of the recurrent Laryngeal Nerve are quite extensive in both the spine and head and neck literature. To the authors' best knowledge, no similar reports have delineated the anatomic relation of the superior Laryngeal Nerve in procedures on the anterior aspect of the cervical spine. METHODS Ten dissections were carried out on human cadavers to show the course of the superior Laryngeal Nerve. Particular attention was directed to the internal branch of the superior Laryngeal Nerve to show the overall anatomic relation relative to standard landmarks. These landmarks included the superior Laryngeal and superior thyroid arteries, the split of the superior Laryngeal Nerve, and the intervertebral disc space. RESULTS The superior Laryngeal Nerve originates from the vagus Nerve in the carotid sheath and bifurcates into internal and external branches. Distally, the internal branch of the superior Laryngeal Nerve courses in close proximity with the superior Laryngeal artery and inserts within 1 cm superior to the superior Laryngeal artery into the thyrohyoid membrane. With respect to the cervical spine, the distal of portion of the internal branch of the superior Laryngeal Nerve is located between the C3 and C4 vertebral bodies. CONCLUSIONS The internal branch of the superior Laryngeal Nerve supplies innervation to the mucosa of the larynx and has an important sensory reflex that serves to protect the lungs from aspiration. Injury to this Nerve can predispose the patient to life-threatening pneumonia. It is therefore imperative for the surgeon to recognize the location and course of this Nerve to avoid injuring it. Injury most commonly occurs either by excessive retraction in different planes or by accidental ligation of the Nerve.
Maria Grazia Lo Schiavo - One of the best experts on this subject based on the ideXlab platform.
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the recurrent Laryngeal Nerve related to thyroid surgery
American Journal of Surgery, 1999Co-Authors: Giovanni Sturniolo, C Dalia, A Tonante, E Gagliano, Filippo Taranto, Maria Grazia Lo SchiavoAbstract:Abstract Background: Iatrogenic injury of inferior Laryngeal Nerve is one of the most serious concerns in thyroid surgery. Paralysis of vocal cords is a common sequela of thyroidectomy. It represents a serious complication inducing, when bilateral, serious functional sequelae such as phonatory, respiratory and psychological problems that limit working capacities and social relationships of patients. We carried out an intraoperative study aimed to define anatomical relationships between the recurrent Laryngeal Nerve and the adjacent structures (the inferior thyroid artery in particular), intraoperative identification of which may allow prevention of iatrogenic injuries of the Laryngeal Nerve. Methods: One hundred ninety-two patients (165 females, 27 males whose age was between 18 and 90 years, median age 55) who had undergone thyroidectomy in our department in the last 3 years. Among them, 179 patients underwent total extracapsular thyroidectomy, and of the 13 remaining, 12 were completions of thyroidectomy in patients who had previously undergone a first thyroid surgical intervention and underwent istmo-lobectomy. Results: Despite a systematic intraoperative search, we identified the recurrent Laryngeal Nerve in 158 of 192 patients (82.3%), while in the remaining 34 (17.7%), the recurrent Laryngeal Nerve was not identified. In 122 out of the 158 patients (77.2%) in whom the recurrent Laryngeal Nerve had been detected, the Nerve was identified bilaterally: in 19 of 158 (12%) only on the right side; in 17 of 158 (10.7%) only on the left. Concerning the postoperative results we noticed only one case (0.5%) of recurrent Laryngeal Nerve injury for neoplastic infiltration of its own branch, one case (0.5%) of monolateral cordal hypomotility, and two cases (1.04%) of bilateral cordal hypomotility with temporary disphonia, which regressed in 6 months of time. Conclusion: The results of our study may confirm that iatrogenic injury to the recurrent Laryngeal Nerve, or to its branches, might be better avoided by searching, identifying, and exposing the Nerve itself and by following its course with care. In our view, total extracapsular thyroidectomy, with systematic search for the Nerve, is the best approach. We believe that deep knowledge of the thyroid region’s surgical anatomy and the awareness of the extremely varying course of the recurrent Laryngeal Nerve and the inferior thyroid artery and their relations should be taken into account by surgeons.
