A Novel Surgical Landmark to Identify the Recurrent Laryngeal Nerve

IF 1.9 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Balkan Medical Journal Pub Date : 2024-07-05 Epub Date: 2024-06-10 DOI:10.4274/balkanmedj.galenos.2024.2024-2-2
Yusuf Dündar, Cynthia M Schwartz, Micah Lierly, Tam Q Nguyen, Kerry K Gilbert, Drew H Smith, Nadia Tello, Joehassin Cordero
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Abstract

Background: Although several surgical landmarks have been proposed to localize the recurrent laryngeal nerve (RLN), there is still no reliable landmark.

Aims: To validate the reliability of a novel reference point at the intersection of the inferior border of the cricopharyngeal muscle and the inferior cornu of thyroid cartilage for locating the RLN.

Study design: Cadaver dissection study in the academic department of otolaryngology-head and neck surgery.

Methods: Sixty-four RLNs in cadavers were assessed, and measurements of different surgical landmarks in conjunction with the proposed surgical landmark were obtained. Descriptive statistics, Pearson’s chi-squared test, and Student’s t-test were performed to analyze the data using GraphPad Prism (version 9.4.1; Dotmatics, Boston, Massachusetts, USA).

Results: The average distance from the proposed landmark to the RLN was 2.3 ± 0.85 mm. The RLN was located just posterior to the reference point in 95.31% of the cadavers. The RLN passed under the inferior constrictor muscle in 90.63% of the cadavers. There was no statistically significant difference between right- and left-sided RLNs in terms of their relation with the reference point.

Conclusion: The proposed reference point can be used as a reliable landmark to locate the RLN. This reference point may help surgeons during difficult thyroidectomy surgeries by providing an additional anatomical landmark.

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识别喉返神经的新手术地标
背景:目的:验证环咽肌下缘与甲状软骨下角交汇处的新参考点在定位喉返神经方面的可靠性:研究设计:耳鼻咽喉头颈外科的尸体解剖研究:方法:对尸体上的64个RLN进行评估,并结合建议的手术地标对不同的手术地标进行测量。使用 GraphPad Prism(版本 9.4.1;Dotmatics,波士顿,马萨诸塞州,美国)对数据进行描述性统计、皮尔逊卡方检验和学生 t 检验:从建议的地标到 RLN 的平均距离为 2.3 ± 0.85 mm。在 95.31% 的尸体中,RLN 位于参考点的正后方。90.63%的尸体的 RLN 穿过下收缩肌。右侧和左侧 RLN 与参考点的关系在统计学上没有明显差异:结论:所提出的参考点可作为定位 RLN 的可靠地标。结论:所提出的参考点可作为定位 RLN 的可靠地标,为外科医生进行困难的甲状腺切除手术提供额外的解剖地标。
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来源期刊
Balkan Medical Journal
Balkan Medical Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
4.10
自引率
6.70%
发文量
76
审稿时长
6-12 weeks
期刊介绍: The Balkan Medical Journal (Balkan Med J) is a peer-reviewed open-access international journal that publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports and clinical images, invited reviews, editorials, letters, comments and letters to the Editor including reports on publication and research ethics. The journal is the official scientific publication of the Trakya University Faculty of Medicine, Edirne, Turkey and is printed six times a year, in January, March, May, July, September and November. The language of the journal is English. The journal is based on independent and unbiased double-blinded peer-reviewed principles. Only unpublished papers that are not under review for publication elsewhere can be submitted. Balkan Medical Journal does not accept multiple submission and duplicate submission even though the previous one was published in a different language. The authors are responsible for the scientific content of the material to be published. The Balkan Medical Journal reserves the right to request any research materials on which the paper is based. The Balkan Medical Journal encourages and enables academicians, researchers, specialists and primary care physicians of Balkan countries to publish their valuable research in all branches of medicine. The primary aim of the journal is to publish original articles with high scientific and ethical quality and serve as a good example of medical publications in the Balkans as well as in the World.
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