Effect of Preoperative Carotid Duplex Ultrasound to Prevent Nonrecurrent Laryngeal Nerve Injury During Thyroid Surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 GONGYan-ping ¹ , MABu-yun ² ,  GONGRi-xiang ¹ , ZHUJing-qiang ¹ , LIZhi-hui ¹ , WEITao ¹ , LIUFeng ¹ , WENLe-bin ¹

1. Department of Thyroid and Breast Surgery, West China Hospital Sichuan University, Chengdu 610041, Sichuan Province, China;
2. Department of Ultrasound Diagnosis, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

GONGRi-xiang, Email: gongrixiang@scu.edu.cn

Keywords：

Nonrecurrent laryngeal nerve; Carotid duplex ultrasound; Abnormal right subclavian artery; X-ray chest film; Thyroid surgery

DOI：

10.7507/1007-9424.20150315

Video：

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Objective To investigate the clinical value of cervical vascular color Doppler ultrasound for dignosis of nonrecurrent laryngeal nerve before thyroid surgery. Methods There were 1931 cases of thyroid patients treated between January 2010 to Jule 2014, group these patients according to the results of preoperative chest radiograph examination, the chest radiograph shows abnormal vessels image were group A (45 cases), no abnormalities were group B (1886 cases). Before operaton, made patients of group A to have routine carotid duplex ultrasound to identify whether the right subclavian artery abnormalities. All patients were exposed to conventional methods of recurrent laryngeal nerve during surgery. Results The 45 patients of group A, chest angiography showed 17 cases with right subclavian artery abnormalities, they were confirmed that all the 17 patients were nonrecurrent laryngeal nerve by surgery, no damage cases. The other 28 cases showed a normal right subclavian artery and no cases of nonrecurrent laryngeal nerve. The 1886 patients in group B, surgical exploration found four cases with nonrecurrent laryngeal nerve, injury in 1 case. The 21 patients whose nonrecurrent laryngeal nerve were on the right side, there were no left side with nonrecurrent laryngeal nerve and no co-exist cases of nonrecurrent and recurrent laryngeal nerve. The average exposure time of nonrecurrent laryngeal nerve in patients of group A (17 cases) was significantly shorter than that group B[(4.28±1.08) min vs. (15.50±2.08) min, t=-15.978, P=0.000]. Conclusions The cervical vascular color Doppler ultrasound examination before thyroid surgery can be adjuvant used, if there is the right subclavian artery abnormalities, it showes that there is the right side nonrecurrent laryngeal nerve. So as to effectively prevent the damage of nonrecurrent laryngeal nerve during thyroid surgery.

Citation： GONGYan-ping, MABu-yun, GONGRi-xiang, ZHUJing-qiang, LIZhi-hui, WEITao, LIUFeng, WENLe-bin. Effect of Preoperative Carotid Duplex Ultrasound to Prevent Nonrecurrent Laryngeal Nerve Injury During Thyroid Surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(10): 1218-1221. doi: 10.7507/1007-9424.20150315 Copy

1.	Campbell PR, Serpell JW, Young AE. Non-recurrent laryngeal nerves. The role of digital subtraction angiography to identify subjects. Aust N Z J Surg, 1991, 61(5):358-359.
2.	Salomonowitz E, Edwards JE, Hunter DW, el al. The three types of aortic diverticula. AJR Am J Roentgenol, 1984, 142(4):673-679.
3.	Iacobone M, Viel G, Zanella S, et al. The usefulness of preoperative ultrasonographic identification of nonrecurrent inferior laryngeal nerve in neck surgery. Langenbecks Arch Surg, 2008, 393(5):633-638.
4.	Henry JF, Audiffret J, Denizot A, et al. The nonrecurrent inferior laryngeal nerve:review of 33 cases, including two on the left side. Surgery, 1988, 104(6):977-984.
5.	Toniato A, Mazzarotto R, Piotto A, et al. Identification of the nonrecurrent laryngeal nerve during thyroid surgery:20-year experience. World J Surg, 2004, 28(7):659-661.
6.	Toniato A, Pelizzo MR. Preoperative imaging of nonrecurrent laryngeal nerve. J Am Coll Surg, 2001, 192(3):421-422.
7.	Soustelle J, Vuillard P, Tapissier J, et al. La non recurrence du nerf larynge inferieur. A propos de 9 cas. Lyon Chir, 1976, 72:67-71.[Article French].
8.	Avisse C, Marcus C, Delattre JF, et al. Right nonrecurrent inferior laryngeal nerve and arteria lusoria:the diagnostic and therapeutic implications of an anatomic anomaly. Review of 17 cases. Surg Radiol Anat, 1998, 20(3):227-232.
9.	Lee YS, Son EJ, Chang HS, et al. Computed tomography is useful for preoperative identification of nonrecurrent laryngeal nerve in thyroid cancer patients. Otolaryngol Head Neck Surg, 2011, 145(2):204-207.
10.	Hermans R, Dewandel P, Debruyne F, et al. Arteria lusoria identified on preoperative CT and nonrecurrent inferior laryngeal nerve during thyroidectomy:a retrospective study. Head Neck, 2003, 25(2):113-117.
11.	Annoud B, Aouad R. Non-recurrent inferior laryngeal nerve in thyroid surgery:report of three cases and review of the literature. J laryngol Otol, 2004, 118(2):139-142.
12.	Satoh S, Tachibana S, Yokoi T, et al. Preoperative diagnosis of nonrecurrent inferior laryngeal nerve usefulness of CT and ultrasonography[Article Japanese]. Nihon Jibiinkoka Gakkai Kaiho, 2013, 116(7):793-801.
13.	Raffaelli M, Iacobone M, Henry JF. The "false" nonrecurrent inferior laryngeal nerve. Surgery, 2000, 128(6):1082-1087.

1. Campbell PR, Serpell JW, Young AE. Non-recurrent laryngeal nerves. The role of digital subtraction angiography to identify subjects. Aust N Z J Surg, 1991, 61(5):358-359.
2. Salomonowitz E, Edwards JE, Hunter DW, el al. The three types of aortic diverticula. AJR Am J Roentgenol, 1984, 142(4):673-679.
3. Iacobone M, Viel G, Zanella S, et al. The usefulness of preoperative ultrasonographic identification of nonrecurrent inferior laryngeal nerve in neck surgery. Langenbecks Arch Surg, 2008, 393(5):633-638.
4. Henry JF, Audiffret J, Denizot A, et al. The nonrecurrent inferior laryngeal nerve:review of 33 cases, including two on the left side. Surgery, 1988, 104(6):977-984.
5. Toniato A, Mazzarotto R, Piotto A, et al. Identification of the nonrecurrent laryngeal nerve during thyroid surgery:20-year experience. World J Surg, 2004, 28(7):659-661.
6. Toniato A, Pelizzo MR. Preoperative imaging of nonrecurrent laryngeal nerve. J Am Coll Surg, 2001, 192(3):421-422.
7. Soustelle J, Vuillard P, Tapissier J, et al. La non recurrence du nerf larynge inferieur. A propos de 9 cas. Lyon Chir, 1976, 72:67-71.[Article French].
8. Avisse C, Marcus C, Delattre JF, et al. Right nonrecurrent inferior laryngeal nerve and arteria lusoria:the diagnostic and therapeutic implications of an anatomic anomaly. Review of 17 cases. Surg Radiol Anat, 1998, 20(3):227-232.
9. Lee YS, Son EJ, Chang HS, et al. Computed tomography is useful for preoperative identification of nonrecurrent laryngeal nerve in thyroid cancer patients. Otolaryngol Head Neck Surg, 2011, 145(2):204-207.
10. Hermans R, Dewandel P, Debruyne F, et al. Arteria lusoria identified on preoperative CT and nonrecurrent inferior laryngeal nerve during thyroidectomy:a retrospective study. Head Neck, 2003, 25(2):113-117.
11. Annoud B, Aouad R. Non-recurrent inferior laryngeal nerve in thyroid surgery:report of three cases and review of the literature. J laryngol Otol, 2004, 118(2):139-142.
12. Satoh S, Tachibana S, Yokoi T, et al. Preoperative diagnosis of nonrecurrent inferior laryngeal nerve usefulness of CT and ultrasonography[Article Japanese]. Nihon Jibiinkoka Gakkai Kaiho, 2013, 116(7):793-801.
13. Raffaelli M, Iacobone M, Henry JF. The "false" nonrecurrent inferior laryngeal nerve. Surgery, 2000, 128(6):1082-1087.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of Preoperative Carotid Duplex Ultrasound to Prevent Nonrecurrent Laryngeal Nerve Injury During Thyroid Surgery

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