Recurrent Laryngeal Nerve's Motor Function: Sometimes Motor Fibers May Also Be Located in The Posterior Branch

Sisli Hamidiye Etfal Training and Research Hospital337 enrolled

Overview

The investigators hypothesized that, sometimes the posterior branch of the recurrent laryngeal nerve may also have motor function. The investigators aimed to evaluate motor function of the branches in the branching recurrent laryngeal nerves in this study.

This study group consisted of consecutive patients, undergoing thyroid and parathyroid surgery with IONM. Both anterior and posterior branches of the recurrent laryngeal nerves were assessed separately by both electromyography endotracheal tube for adduction and finger palpation for detection of laryngeal twitch due to posterior cricoarytenoid abduction. The recurrent laryngeal nerves having motor function only in the anterior branches were defined as group 1, whereas the nerves having motor function both in the anterior and posterior branches were as group 2.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

NONE

Enrollment

337

Conditions

Recurrent Laryngeal Nerve Injuries

Interventions

intraoperative neuromonitoringDEVICE

NIM-Response 3.0 Intraoperative Neuromonitoring System (Medtronic Xomed, Jacksonville, FL, USA) was used to record the EMG amplitude signal for the anterior and/or posterior branches of recurrent laryngeal nerves (RLNs).

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patients who underwent parathyroid/thyroid surgery with intraoperative neuromonitoring , 2. Patients who had normal vocal cord functions preoperatively. - Exclusion Criteria: 1. Preoperative recurrent laryngeal nerve palsy, 2. Intentional nerve transection because of cancer invasion, 3. Assessment failure of recurrent laryngeal nerve function due to the deficiency of the intraoperative neuromonitoring equipment,. 4. Parathyroidectomy operations that recurrent laryngeal nerves were not fully dissected. \-

Outcomes

Primary Outcomes

The evoked EMG potentials of the branches of the recurrent laryngeal nerves as microvolt, by intraoperative neuromonitoring.

The nerves , due to having motor functions whether on their anterior or posterior branches, were divided into two groups. The amplitudes of the anterior and posterior branches within the group 2 were compared.

Time frame: intraoperative

Secondary Outcomes

The diameters of the branches of the recurrent laryngeal nerves.

The branch diameters of the recurrent laryngeal nerves were compared between the two groups.

Time frame: intraoperative

The branching distances of the recurrent laryngeal nerves.

The branching distances of the recurrent laryngeal nerves till the entry point into the larynx, were compared between the two groups.

Time frame: intraoperative

Data from ClinicalTrials.gov

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