Original Research Article
Year: 2017 | Month: June | Volume: 4 | Issue: 6 | Pages: 14-19
The Role of Endoscope Assisted Intra-Operative Identification of External Branch of Superior Laryngeal Nerve in the Outcome of Voice Following Thyroid Surgery
Dr. Kripamoy Nath1, Dr. Sanchita Kalita2, Dr. Rohit Tigga3
1Assistant Professor, 2Post Graduate Trainee (MS),
Department of ENT, Silchar Medidal College and Hospital, Assam, India
3Demonstrator, Department of Pharmacology, Silchar Medical College and Hospital, Assam, India.
Corresponding Author: Dr. Sanchita Kalita
Aims: (I) To identify the External Branch of Superior Laryngeal Nerve (EBSLN), along with Recurrent Laryngeal Nerve (RLN), during thyroid surgery by adopting endoscopic magnification along with routine dissection methods. (II) To determine the significance of intra-operative identification of EBSLN for preservation of quality of voice following Thyroid surgery.
Methodology: A prospective institutional comparative study was carried out for 2 years from August 2014 to July 2016 with a sample size of 40 patients, who were admitted for Thyroid surgery. The sample size was divided into two equal groups of 20 patients each. In Group A, Thyroid surgery was conducted by employing conventional dissection techniques, where EBSLN was not identified. In Group B, special care was taken to preserve the EBSLN with the aid of endoscopic magnification. The patients were clinically evaluated for any changes in voice, particularly related to injury to the EBSLN; by assessing for hoarseness of voice, easy fatigability, inability/difficulty to produce high pitch voice; three days and one month following surgery. Furthermore, patients underwent indirect and flexible videolaryngoscopy, and voice recording. The results were statistically evaluated.
Results: Employment of endoscopic magnification along with routine dissection techniques, helped in the preservation of EBSLN in Group B patients. Cernea Type 1 variation was the most common (69%). The voice outcome assessment in Group B patients was found to be superior to that in Group A.
Conclusion: There seems to be an important role of preservation of EBSLN along with RLN during thyroid surgery for conserving a superior quality of voice. Endoscopic magnification aids in identification of EBSLN and its variants.
Key words: EBSLN, RLN, identification, endoscope, voice, thyroid surgery[PDF Full Text]