Cernea's classification of the External Branch of the Superior Laryngeal Nerve during Microscopic Thyroidectomy at Gandaki Medical College, Pokhara

T. Dubey, Brihaspati Sigdel, R. Nepali, N. Kc
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Abstract

Background: Preservation of the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomy is important because its injury may lead to frequent occurrence of vocal fatigue and the inability to perform phonation. The objective of the study was to identify and classify the nerve as per Cernea's classification using operating microscope during thyroidectomy Method: Between January 2017 to December 2019, we evaluated 50 patients for the position of external branch of superior laryngeal nerve, who underwent microscopic thyroid surgeries in the department of ENT- head and neck surgery at Gandaki Medical College. Results: In our study, we dissected a total 59 superior poles of thyroid from 50 patients and identified the nerve in all the cases. Of the total superior poles, 36 (61.01%) had type IIa EBSLN among which 24 was on the right side and 12 on the left followed by 19 (32.20%) patients with type IIb EBSLN among which 8 on right and 11 on left side. There were only 4 poles (6.77%) of type I with 3 on the right and 1 on the left side. Conclusion: The EBSLN can be very efficaciously identified during a microscope assisted thyroidectomy. Cernea type 2a and 2b EBSLNs are in position to be at high risk of injury during ligation of the superior vascular pedicle, which can be avoided by prompt identification through a microscope and a meticulous extra capsular dissection technique.
博卡拉Gandaki医学院显微甲状腺切除术中喉上神经外支的Cernea分类
背景:在甲状腺切除术中保存喉上神经外支(EBSLN)是很重要的,因为它的损伤可能导致声带疲劳和不能发声的频繁发生。方法:2017年1月至2019年12月,在甘达基医学院耳鼻喉头颈外科行显微甲状腺手术的50例患者,对其喉上神经外支的位置进行评估。结果:在我们的研究中,我们共解剖了50例患者的59个甲状腺上极,并确定了所有病例的神经。其中IIa型EBSLN 36例(61.01%),右侧24例,左侧12例;IIb型EBSLN 19例(32.20%),右侧8例,左侧11例。I型仅有4个(6.77%),其中3个在右侧,1个在左侧。结论:显微镜辅助甲状腺切除术能很好地识别EBSLN。Cernea 2a型和2b型ebsln在上血管蒂结扎过程中处于损伤的高危位置,通过显微镜及时识别和细致的囊外剥离技术可以避免损伤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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