The usefulness of preoperative ultrasonographic identification of nonrecurrent inferior laryngeal nerve in neck surgery

Backgrounds and aims Nonrecurrent inferior laryngeal nerve (ILN) represents a risk factor for injury during neck surgery. It is associated to arterial abnormalities (absence of the brachiocephalic trunk and arteria lusoria) that can be identified by ultrasonography. The aim of the study was to verif...

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Bibliographic Details
Published in:Langenbeck's archives of surgery 2008-09, Vol.393 (5), p.633-638
Main Authors: Iacobone, Maurizio, Viel, Giovanni, Zanella, Simone, Bottussi, Marzia, Frego, Mauro, Favia, Gennaro
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Aged
Brachiocephalic Trunk - abnormalities
Brachiocephalic Trunk - diagnostic imaging
Cardiac Surgery
Current Concepts in Endocrine Surgery
Female
General Surgery
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Parathyroid Diseases - surgery
Postoperative Complications - prevention & control
Preoperative Care
Recurrent Laryngeal Nerve - abnormalities
Recurrent Laryngeal Nerve - diagnostic imaging
Recurrent Laryngeal Nerve Injuries
Sensitivity and Specificity
Thoracic Surgery
Thyroid Diseases - surgery
Traumatic Surgery
Ultrasonography
Vascular Surgery
Vocal Cord Paralysis - prevention & control
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Summary:Backgrounds and aims Nonrecurrent inferior laryngeal nerve (ILN) represents a risk factor for injury during neck surgery. It is associated to arterial abnormalities (absence of the brachiocephalic trunk and arteria lusoria) that can be identified by ultrasonography. The aim of the study was to verify the usefulness of preoperative ultrasonography in the research of nonrecurrent ILN by the means of identification of arterial abnormalities and the impact on ILN morbidity. Patients and methods The study included 750 patients who underwent neck surgery with right-side ILN dissection. A preoperative ultrasonography aimed to identify arterial abnormalities associated to nonrecurrent ILN was performed in 400 patients (Group A) while no preoperative attempts were performed in the remaining patients (Group B). Patients’ characteristics, time for intraoperative identification of the ILN, and morbidity were compared. Results Five and four nonrecurrent ILN were identified in groups A and B, respectively ( p  = NS). Preoperative ultrasonography correctly predicted nonrecurrent ILN in all cases (accuracy 100%). Nonrecurrent ILN palsy never occurred in group A, while three cases occurred in group B ( p  
ISSN:1435-2443
1435-2451
DOI:10.1007/s00423-008-0372-9