2018 Section 6 - Laryngology, Voice Disorders, and Bronchoesophalogy

Reprinted by permission of Auris Nasus Larynx. 2017; 44(5):583-589.

Auris Nasus

Larynx

44

(2017)

583 – 589

Contents

lists

available

at ScienceDirect

Auris Nasus

Larynx

jou rnal

homepage:

www.elsevier.com/locat e/anl

Efficiency

of

intraoperative

neuromonitoring

on

voice

outcomes

after surgery Seung-Kuk Baek 1 , Kijeong Lee 1 , Dongju Oh, Sung Hoon Kang, Soon-Young Kwon, Jeong-Soo Woo, Jae-Gu Cho, Kyung Ho Oh, Doh Young Lee, Kwang-Yoon Jung * Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea thyroid

A

R

T

I

C

L

E

I

N

F

O

A

B

S

T

R

A

C

T

Voice

disturbance

is

an

important

problem

after

thyroidectomy. The

aim

of

this

study early

Article

history:

Objective:

3 November

2016

Received Accepted Available

was

to

evaluate

the

efficiency comparing

of

intraoperative

neuromonitoring

(IONM)

in

reducing

27

January

2017

change

by

postoperative

voice

outcomes.

phonation Methods:

online

21

February

2017

The

study

retrospectively

enrolled thyroid

68

consecutive

female

patients who

had

undergone

IONM

thyroidectomy

for

papillary

carcinoma

occurring

between

January

2014

and

Keywords: Neuromonitoring Recurrent

2014.

A

historical

group

of

117

similar

female

patients

not

receiving

IONM

November

thyroidectomy was

used

as

an

external

control. Voice

analyses were

performed

preoperatively IONM group

laryngeal

nerve

and at 1 week, 1 month,

and 3 months postoperatively. Voice outcomes between the

Voice Surgery Thyroid

no

IONM

group

were

compared

in

patients

who

underwent

hemithyroidectomy

and

total

and

thyroidectomy. Results: In

patients

who

underwent

IONM,

there

were

significantly

smaller

changes

in

the

fundamental

frequency at postoperative 1 month and in

the maximum voice pitch of

the voice

range

at

postoperative

1 week

irrespective

of

the

extent

of

thyroid

surgery.

profile

IONM

during

thyroid

surgery

resulted

in

better

outcomes

regarding

fundamental

Conclusion:

frequency

and

high-pitch

voice

in

the

early

postoperative

period.

IONM

appears

to

be

an

effective

to

reduce

temporary

phonation

alteration

after

thyroid

surgery.

method

©

2017

Elsevier B.V. All

rights

reserved.

1. Introduction

and

EBSLN

during

thyroid

surgery

is

very

important

to

RLN

vocal

function.

maintain

disturbance

is

one

of

the

most

important

problems

Voice

nerve

monitoring

(IONM) identify

has

been

intro-

Intraoperative

thyroid

surgery

[1] .

Injury of

the

recurrent

laryngeal nerve

after

as

a

technique addition,

that

can help

to

and preserve both

duced nerves. nitoring surgery quality

(RLN)

is considered

to be

the main cause of post-thyroidectomy

In

international

guidelines

for

the

neuromo- parathyroid

changes.

In

addition, damage (EBSLN)

the

problem

of

high-pitched

phonatory

of

RLN

and

EBSLN

during

thyroid

and

is

associated with laryngeal nerve

to

the

external

branch

of

the the

voice

were

introduced

in

2011

and

2013

to

improve

the

[2] . Thus, preservation of

superior

and

safety

of monitoring

[3,4] .

of

the are

voice

changes

after with

thyroidectomy

are

self-

Most

and

not

associated

an

impairment

of

nerve

limited

These

alterations may

be

associated with

vocal

fold

function.

* Corresponding author at: Anam-dong 5-ga 126-1, Seongbuk-gu, Seoul 136- 705, Republic of Korea. E-mail address: kyjungmd@gmail.com (K.-Y. Jung). 1 Seung-Kuk Baek and Kijeong Lee contributed equally to this work.

trauma

following endotracheal

intubation

change and arytenoid

with

surgical

trauma

and

laryngotracheal

fixation

of

the and

or

strap

muscles

[5] .

However,

undetectable

pre-laryngeal

http://dx.doi.org/10.1016/j.anl.2017.01.009 0385-8146/© 2017 Elsevier B.V. All rights

reserved.

111