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Case Reports
. 2022 Jul 25;10(7):e6137.
doi: 10.1002/ccr3.6137. eCollection 2022 Jul.

Intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgery

Carta Filippo  1 , Marrosu Valeria  1 , Pinto Valeria  1 , Tatti Melania  1 , Mauro Bontempi  1 , Mariani Cinzia  1 , Puxeddu Roberto  1
Affiliations
Case Reports

Intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgery

Carta Filippo et al. Clin Case Rep. .

Erratum in

  • Corrigendum.
    [No authors listed] [No authors listed] Clin Case Rep. 2022 Sep 16;10(9):e6259. doi: 10.1002/ccr3.6259. eCollection 2022 Sep. Clin Case Rep. 2022. PMID: 36177074 Free PMC article.

Abstract

The most common surgical risk after total thyroidectomy remains the recurrent laryngeal nerve (RLN) injury. Nowadays, the use of intraoperative nerve monitoring systems (IONM) such as the endotracheal tube-based is recommended to prevent RLN palsy. The use of the nerve monitoring is standardized by dedicated guidelines on the basis of a normal laryngeal anatomy, but previous head and neck surgical procedures may complicate its application. The authors herewith present a case of a non-conventional use of endotracheal tube-based IONM in a 72-year-old patient who underwent to a second-stage total thyroidectomy for metastatic papillary cancer incidentally detected after an open partial horizontal laryngectomy (OPHL) extended to one arytenoid (Type IIa + ary left) for squamous cell carcinoma. The use of the endotracheal tube-based IONM in such particular case where the function of the only remaining arytenoid had to be absolutely preserved was effective in avoiding the RLN accidental injury. The authors reviewed the non-traditional use of IONM and described the procedure in case of thyroidectomy in patients previously treated by OPHL.

Keywords: OPHL; intraoperative nerve monitoring; metastatic papillary cancer; partial laryngectomy; thyroid cancer.

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Conflict of interest statement

The authors declare that this manuscript was conceived and written by the cited authors, they do not have any financial interests to disclose, and they confirm no conflict of interest concerning this manuscript.

Figures

FIGURE 1
FIGURE 1
Endoscopic view of endotracheal tube‐based neuromonitoring position: the right electrode (white band) leans on the remnant crico‐arytenoid unit (*)
FIGURE 2
FIGURE 2
RLN isolated
FIGURE 3
FIGURE 3
Recurrent laryngeal nerve electric response
FIGURE 4
FIGURE 4
Post‐op endoscopic features of new larynx during abduction
FIGURE 5
FIGURE 5
Post‐op endoscopic features of new larynx during adduction
See this image and copyright information in PMC

References

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