The anatomy of the external branch of the superior laryngeal nerve in Koreans.

Abstract:

BACKGROUND:Preservation of the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomy is important because its injury may lead to frequent occurrence of vocal fatigue and the inability to perform superenergetic phonation. Most studies on the anatomy of EBSLN have been performed in Western countries and, thus, have some limitations in their application to Koreans. We explored the anatomy of EBSLNs using intraoperative neuromonitoring (IONM) in Korean adults. METHODS:Between August 2011 and December 2011, 50 patients underwent thyroidectomy at Korea University, Anam Hospital in Seoul, Korea. IONM was performed with the NIM response 3.0 system. RESULTS:Forty-two total thyroidectomies and eight lobectomies were performed with IONM and 92 EBSLNs were evaluated. Type I EBSLN was observed in 15 of the 92 nerves (16.3%), type IIa EBSLN was noted in 52 (56.5%) and type IIb EBSLN was noted in 25 (27.2%). Patients with types IIa and IIb were at higher risk of injuries and these types were more frequently observed (83.7%) compared with previous Western studies. We found that 35.9% of distal insertion sites of EBSLNs were located within 1cm of the center of the cricoid cartilage. CONCLUSION:Surgeons should pay close attention to preserving the EBSLN during thyroidectomy in Korean patients because their EBSLNs are more frequently located beneath the superior thyroid vessels.

journal_name

Asian J Surg

journal_title

Asian journal of surgery

authors

Hwang SB,Lee HY,Kim WY,Woo SU,Lee JB,Bae JW,Kim HY

doi

10.1016/j.asjsur.2012.08.003

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

13-9

issue

1

eissn

1015-9584

issn

0219-3108

pii

S1015-9584(12)00123-6

journal_volume

36

pub_type

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