Non-Recurrent Laryngeal Nerve: Surgical Risk of Injury in Comparison With the Normal Recurrent Laryngeal Nerve—A Systematic Review and Meta-Analysis

IF 1.5 4区 医学 Q2 OTORHINOLARYNGOLOGY
Jensen Tsun-Ki So, C. S. G. Thompson
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引用次数: 0

Abstract

Introduction

The non-recurrent laryngeal nerve (NRLN) is a known anatomical variation of the normal recurrent laryngeal nerve (RLN). Its prevalence is estimated to be < 1% and has a higher risk of iatrogenic injury. The risk during thyroid surgery has been reported variably in current literature, from 0% to 12%. This study aimed to systematically review the incidence of NRLN injury and present the results through meta-analysis. The incidence of injury to NRLN and RLN was compared statistically to determine its significance.

Methods

The PRISMA protocol was followed for an online search of prominent literatures. Studies were selected according to specific criteria. Quality assessment was performed before data extraction. Meta-analysis was conducted for the incidence of injury of the NRLN and its comparison to the RLN. Results were presented in the form of a systematic review.

Results

Final analysis included 17 studies. The pooled risk of NRLN injury was 7% and the risk ratio of injury in comparison to the RLN was 3.8, showing a statistically significant difference.

Conclusion

This is the first study to report the overall risk of NRLN injury and establish a statistically significant difference compared to the injury of the normal RLN. The NRLN is highly associated with the vascular anomaly of aberrant subclavian artery, which is radiologically predictable. The use of intra-operative nerve monitoring can significantly reduce the risk of injury to this nerve when it is identified pre-operatively, and the thyroid surgery should be performed by experienced thyroid surgeons with extra care to minimise the risk.

非喉返神经:手术损伤风险与正常喉返神经的比较——系统回顾和荟萃分析。
简介:喉返神经(NRLN)是一种已知的正常喉返神经(RLN)的解剖变异。方法:采用PRISMA协议对著名文献进行在线检索。根据特定的标准选择研究。数据提取前进行质量评估。对NRLN损伤发生率及其与RLN的比较进行meta分析。结果以系统评价的形式呈现。结果:最终分析包括17项研究。NRLN损伤的总风险为7%,与RLN损伤的风险比为3.8,差异有统计学意义。结论:该研究首次报道了NRLN损伤的总体风险,并与正常RLN损伤建立了统计学上的显著差异。NRLN与异常锁骨下动脉的血管异常高度相关,这在放射学上是可预测的。术中神经监测的使用可以显著降低术前识别该神经损伤的风险,甲状腺手术应由经验丰富的甲状腺外科医生进行,以尽量减少风险。
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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来源期刊
Clinical Otolaryngology
Clinical Otolaryngology 医学-耳鼻喉科学
CiteScore
4.00
自引率
4.80%
发文量
106
审稿时长
>12 weeks
期刊介绍: Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.
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