PREOPERATIVE FACTORS THAT AID IN DETERMINING PROBABLE TYPE OF EXTERNAL BRANCH OF SUPERIOR LARYNGEAL NERVE AND AID IN SURGICAL PLANNING FOR ITS IDENTIFICATION DURING THYROIDECTOMY aadarshraghavan@gmail.com

 

PREOPERATIVE FACTORS THAT AID IN DETERMINING PROBABLE TYPE OF EXTERNAL BRANCH OF SUPERIOR LARYNGEAL NERVE AND AID IN SURGICAL PLANNING FOR ITS IDENTIFICATION DURING THYROIDECTOMY

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India

Oral only

External Branch of Superior Laryngeal Nerve (EBSLN) has a varied anatomy and its identification and preservation are key for high-pitched voice. It is the most common nerve injured during thyroidectomy

To look for preoperative factors associated with a lower placed EBSLN (Type IIA IIB) and aid in surgical planning for its anticipation and identification during thyroidectomy 314 patients were included in this retrospective study at Department of Endocrine Surgery, Madras Medical College. Parameters such as age, gender, BMI, Volume of each lobe measured by Ultrasound, presence of hyperthyroidism and malignancy noted pre-operatively and during surgery EBSLN was identified and recorded using Cernea et al classification into type I, IIA and IIB

All the data collected were analysed using SPSS software. A total of 612 nerves were identified. Right side Type I (140) Type IIA (146) Type IIB (12) Left side Type I (166) Type IIA (128) Type IIB (10). Patients with hyperthyroidism 65% cases (p value 0.03) or large volume gland 56% cases (>50ml each lobe) (p value 0.007) on right side and 50% cases (p value <0.001) on left side had lower placed nerves (IIA and IIB)A Stronger association was noted (p value <0.001) especially with raised craniocaudal measurements in 65% cases (>6 cm)(p value <0.001) on right side and 59% cases (p value <0.001) on left side when hyperthyroidism and large volume gland were associated together

Large volume gland and hyperthyroidism independently and together with raised craniocaudal measurements were associated with a lower placed EBSLN