Dokumentdetails
ID
doi:10.1007/s00423-024-03323-x...
Autor
Peng, Jieying Zhu, Guanghao Gao, Yingna Song, Xianmin Yu, Haojun Huang, Rushi Chen, Mengjie Jiang, Yafei Sun, Guodong Li, Meng Zheng, Hongliang Wang, WeiLangue
enEditor
Springer
Kategorie
Medicine & Public Health
Jahr
2024
Auflistungsdatum
01.05.2024
Schlüsselwörter
recurrent laryngeal nerve vocal fold paralysis laryngeal reinnervation ansa cervicalis arytenoid adduction thyroid carcinoma rln macis infiltrated voice thyroid carcinoma patients resectionZusammenfassung
Purpose Treating an infiltration of the recurrent laryngeal nerve (RLN) by thyroid carcinoma remains a subject of ongoing debate.
Therefore, this study aims to provide a novel strategy for intraoperative phenosurgical management of RLN infiltrated by thyroid carcinoma.
Methods Forty-two patients with thyroid carcinoma infiltrating the RLN were recruited for this study and divided into three groups.
Group A comprised six individuals with medullary thyroid cancer who underwent RLN resection and arytenoid adduction.
Group B consisted of 29 differentiated thyroid cancer (DTC)patients who underwent RLN resection and ansa cervicalis (ACN)-to-RLN anastomosis.
Group C included seven patients whose RLN was preserved.
Results The videostroboscopic analysis and voice assessment collectively indicated substantial improvements in voice quality for patients in Groups A and B one year post-surgery.
Additionally, the shaving technique maintained a normal or near-normal voice in Group C one year post-surgery.
Conclusion The new intraoperative phonosurgical strategy is as follows: Resection of the affected RLN and arytenoid adduction is required in cases of medullary or anaplastic carcinoma, regardless of preoperative RLN function.
Suppose RLN is found infiltrated by well-differentiated thyroid cancer (WDTC) during surgery, and the RLN is preoperatively paralyzed, we recommend performing resection the involved RLN and ACN-to-RLN anastomosis immediately during surgery.
If vocal folds exhibit normal mobility preoperatively, the MACIS scoring system is used to assess patient risk stratification.
When the MACIS score > 6.99, resection of the involved RLN and immediate ACN-to-RLN anastomosis were performed.
RLN preservation was limited to patients with MACIS scores ≤ 6.99.
Peng, Jieying,Zhu, Guanghao,Gao, Yingna,Song, Xianmin,Yu, Haojun,Huang, Rushi,Chen, Mengjie,Jiang, Yafei,Sun, Guodong,Li, Meng,Zheng, Hongliang,Wang, Wei, 2024, New strategy for intraoperative phonosurgical management of recurrent laryngeal nerve infiltrated by thyroid carcinoma, Springer
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