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. 2024 Feb 4;24(1):46.
doi: 10.1186/s12893-023-02287-x.

"VSports app下载" Is identification and dissection of the external laryngeal nerve necessary during thyroidectomy? A prospective study

Soukayna Bourabaa  1 , Abdellatif Settaf  2
Affiliations

Is identification and dissection of the external laryngeal nerve necessary during thyroidectomy? A prospective study

Soukayna Bourabaa et al. BMC Surg. .

Abstract

Background: Compared to the recurrent laryngeal nerve, the EBSLN (or external laryngeal nerve) is less studied in terms of its course and relationship with the thyroid gland. This is a prospective intraoperative study designed to identify the anatomical variations of the EBSLN in relation to the IPC, the superior thyroid pedicle, and the point where the nerve crosses the STA VSports手机版. Additionally, the study aims to propose a technical procedure for its preservation. .

Methods: We conducted a prospective study of 50 patients (total of 100 nerves) undergoing total thyroidectomy at the Department of Surgery 'B' in Ibn Sina Hospital, Rabat. Intraoperatively, the EBSLN was visually identified and preserved before ligating the superior thyroid vessels. Each nerve was categorized using established classification systems V体育安卓版. .

Results: The overall pooled EBSLN identification rate was 82%. Cernea type IIa (nerves crossing the STA less than 1 cm above the upper edge of the superior thyroid pole) and Friedman type II (nerves piercing the lower fibers of the IPC) were the most prevalent (64% and 44%, respectively). Kierner type IV (nerves crossing the branches of the STA immediately above the upper pole of the thyroid gland) was represented in 27% of cases V体育ios版. .

Conclusion: A better understanding of surgical anatomy of the neck allows for better results of thyroidectomy by preserving the external and recurrent laryngeal nerves VSports最新版本. .

Keywords: External branch of the superior laryngeal nerve; External laryngeal nerve; Thyroidectomy. V体育平台登录.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Friedman classification [3]. Type I: The EBSLN runs its whole course superficially or laterally to the IPC, descending with the superior thyroid vessels until it terminates in the CTM. Type II: the EBSLN penetrates the IPC about 1 cm proximal of the CTM. Type III: The EBSLN dives under the superior fibers of the IPC, remaining covered by this muscle throughout its course to the CTM
Fig. 2
Fig. 2
Cernea classification. Type I: The EBSLN crosses the STA more than 1 cm above the upper edge of the superior thyroid pole. Type IIa: The EBSLN crosses the STA less than 1 cm above the upper edge of the superior thyroid pole. Type IIb: The EBSLN crosses the STA below the upper edge of the superior thyroid pole
Fig. 3
Fig. 3
Classification of the EBSLN pathway according to Kierner. Type I: The artery-nerve crossing is more than 1 cm from the upper pole of the thyroid gland. Type II: The artery-nerve crossing is less than 1 cm above the upper pole of the thyroid gland. Type III: The artery-nerve crossing is above the upper pole of the thyroid gland. Type IV: The EBSLN descends dorsally and crosses the branches of the STA immediately above the upper pole of the thyroid gland
Fig. 4
Fig. 4
Type IIb Cernea and III Kierner where the nerve runs below the upper pole of the thyroid
Fig. 5
Fig. 5
Type IV Kierner where the external laryngeal nerve passes between the trifurcation branches of the STA
Fig. 6
Fig. 6
Distribution of nerves based on classification systems
Fig. 7
Fig. 7
a Anatomy of the superior laryngeal nerve. b Connections of the EBSLN
Fig. 8
Fig. 8
Elective ultraligation of the superior thyroid artery divisions
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