Professor Henning Dralle Receives Prestigious Award for "Intraoperative Monitoring of the Recurrent Laryngeal Nerve
in Thyroid Surgery"
The left vagus nerve gives rise to the left recurrent laryngeal nerve
as the vagus nerve descends just lateral and anterior to the arch of the aorta.
Missing denture as a cause of recurrent laryngeal nerve
In addition to each patient's age at presentation and sex, information was collected on 8 possible predictive factors for respiratory complications: (1) the duration of the goiter, (2) the preoperative status of the recurrent laryngeal nerve
, (3) the presence or absence of tracheal narrowing or deviation, (4) the presence or absence of retrosternal extension, (5) the ease or difficulty of endotracheal intubation, (6) the presence or absence of thyroid cancer, (7) the presence or absence of giant goiter, and (8) whether or not the goiter represented a recurrence.
At the time of surgery, an endotracheal tube with incorporated electrodes or a recurrent laryngeal nerve
surface electrode plate is placed.
A significant number of articles has been published on electrophysiologic monitoring of (1) the facial nerve during otologic and parotid surgery and (2) the recurrent laryngeal nerve
during thyroid and parathyroid surgery.
4) In these locations, the nerve of origin is likely to be the recurrent laryngeal nerve
or the internal branch of the superior laryngeal nerve.
In contrast, our patient presented with dysphagia, as well as hoarseness, which was caused by vocal fold paralysis as a result of compression of the recurrent laryngeal nerve
and was confirmed by diagnostic imaging.
One much debated, Occam's-razor-be-damned counterexample: there's no godly reason why the left recurrent laryngeal nerve
(LRLN), which keeps us all from sounding like a whispering Minnie Mouse, has to lasso the heart on its way from the brain to the larynx, a detour the equivalent of driving from Louisville to St.
The recurrent laryngeal nerve
(important for respiration) the superior laryngeal nerve (for voice) and parathyroids (for calcium metabolism) with their blood supply can thus be preserved.
7) This patient's clinical presentation of hoarseness of voice was caused by paralysis of the recurrent laryngeal nerve
due to compression of the nerve by the large saccular aneurysm arising from the aortic arch.
Other postoperative complications were cardiac dysrhythmias (n = 2), recurrent laryngeal nerve
paresis (n = 2), anastomotic leak that was treated medically (n = 2), thoracic empyema (n = 1), and chylothorax (n = 1; Table 1).