To investigate time of delayed reinnervated laryngeal muscle, 15 dogs were divided into two groups. The right recurrent laryngeal nerves of 10 dogs in experimental group were cut, and repaired at 4, 6, 8, 10 and 12 months intervals by transposition of the phrenic nerve to the recurrent laryngeal nerve after cutting and suturing the adductor branch to the main branch of ansa cervicalis. The right recurrent laryngeal nerves of 5 dogs in control group were cut, but did not repair. Laryngoscope, electromyography, contractile tension of laryngeal muscle and histologic studies were performed at six months postoperatively. The results showed that fair recovery of adduction and abduction was noted within ten months interval, and the effect of adduction was better than that of abduction. The effect decreased gradually with the denervated time increased. The conclusion demonstrated that delayed reinnervation of laryngeal muscle should be performed within ten months.
Objective To compare the advantages and disadvantages of using the harmonic scalpel and bipolar coagulation forceps versus harmonic scalpel and conventional clamp-and-tie technique in open thyroid surgery.Methods One hundred patients indicated for thyroid surgery were randomly divided into two groups：the bipolar coagulation forceps group underwent surgery with harmonic scalpel and bipolar coagulation forceps，and the conventional clamp-and-tie group with harmonic scalpel and conventional clamp-and-tie technique，respectively.All operations were performed by the same group of doctors.The total operation time，intraoperative bleeding，mass diameter，postoperative drainage，and surgical complications （postoperative bleeding， postoperative recurrent laryngeal nerve paralysis，seroma，and permanent postoperative hypoparathyroidism） were compared.Results There were 48 valid cases in the bipolar coagulation forceps group， and 49 cases in the conventional clamp-and-tie group. There were no significant differences between two groups patients of age，gender，disease composition，and mass diameter（P＞0.05）.With the same operative approach， the total operation time，intraoperative bleeding，and the incidence of transient postoperative hypoparathyroidism in the bipolar coagulation forceps group were significantly lower than those in the conventional clamp-and-tie group （P＜0.001）.The postoperative drainage in the bipolar coagulation forceps group was more than that in the conventional clamp-and-tie group （P＜0.05）.There was no single case of postoperative bleeding，postoperative recurrent laryngeal nerve paralysis，seroma，and permanent postoperative hypoparathyroidism in both groups.Conclusions The combination of harmonic scapel with bipolar coagulation forceps provides significant advantages over the combination of harmonic scapel with conventional clamp-and-tie technique in open thyroid surgery.