ArticleSurgery today2016
Prospective validation study of Cernea classification for predicting EMG alterations of the external branch of the superior laryngeal nerve.
Article in Surgery today, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Surgical anatomy of the external branch of the superior laryngeal nerve: a systematic review and meta-analysis.Langenbeck's archives of surgery · 2018Pooled it
- Contribution of intraoperative neural monitoring to preservation of the external branch of the superior laryngeal nerve: a randomized prospective clinical trial.Langenbeck's archives of surgery · 2017Trial
- Dissecting and stimulating instruments in thyroid surgery: principles, applications and clinical role.Frontiers in medical technology · 2026Article
- Intraoperative cricothyroid muscle electromyography may contribute to the monitorization of the external branch of the superior laryngeal nerve during thyroidectomy.Frontiers in endocrinology · 2023Article
- Assessment of different classification systems for predicting the risk of superior laryngeal nerve injury during thyroid surgery: a prospective cohort study.Frontiers in endocrinology · 2023Article
- Can we routinely identify the external branch of the superior laryngeal nerves with neural monitoring?: a prospective report on 176 consecutive nerves at risk.Updates in surgery · 2021Article
- Improving classification of the external branch of the superior laryngeal nerve with neural monitoring: a research appraisal and narrative review.Gland surgery · 2021Review
- Unmapped landmarks around branches of the Superior Laryngeal Nerve: An exploratory cadaveric study.Journal of Taibah University Medical Sciences · 2021Article
- Perceptual Assessment and Acoustic Voice Analysis as Screening Tests for Vocal Fold Paresis After Thyroid or Parathyroid Surgery.World journal of surgery · 2021Article
- Anatomical, Functional, and Dynamic Evidences Obtained by Intraoperative Neuromonitoring Improving the Standards of Thyroidectomy.Sisli Etfal Hastanesi tip bulteni · 2021Review
- The area under the waveform of electromyography for monitoring the external branches of the superior laryngeal nerve during thyroid surgery.Gland surgery · 2021Article
- Informed Consent for Intraoperative Neural Monitoring in Thyroid and Parathyroid Surgery - Consensus Statement of the International Neural Monitoring Study Group.Frontiers in endocrinology · 2021Review
- Training Courses in Laryngeal Nerve Monitoring in Thyroid and Parathyroid Surgery- The INMSG Consensus Statement.Frontiers in endocrinology · 2021Article
- Strategies for superior thyroid pole dissection in transoral thyroidectomy: a video operative guide.Surgical endoscopy · 2020Article
- A useful landmark to locate the external branch of the superior laryngeal nerve during thyroidectomy.Gland surgery · 2020Article
- Article
- A Review of Methods for the Preservation of Laryngeal Nerves During Thyroidectomy.Sisli Etfal Hastanesi tip bulteni · 2018Review
- Injury of the external branch of the superior laryngeal nerve in thyroid surgery.Gland surgery · 2017Review
- Contribution of intraoperative neuromonitoring to the identification of the external branch of superior laryngeal nerve.Turkish journal of surgery · 2017Article
- Post-thyroidectomy complications in southwestern Saudi Arabia: a retrospective study of a 6-year period.Annals of Saudi medicineArticle
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposesCernea classification is applied to describe the external branch of the superior laryngeal nerve (EBSLN). Using intraoperative neural monitoring we evaluated whether or not this classification is useful for predicting which EBSLN subtype has an increased risk of injury.
methodsAn analysis of 400 EBSLN. The identification of EBSLN was achieved with both cricothyroid muscle twitch and the glottis evoked electromyography response. We defined S1 initial EBSLN stimulation at identification and S2 final nerve stimulation achieved in the most cranial aspect of the nerve exposed above the area of surgical dissection after superior artery ligation.
resultsThe mean S1 amplitude acquired was 259+/67 (180-421), 321 +/79 (192-391), 371 +/38 (200-551) μV, respectively, for type 1, 2A, 2B (p = 0.08). The S1 and S2 amplitudes were similar in type 1 (p = 0.3). The S1 and S2 determinations changed significantly in type 2A and 2B (p = 0.04 and 0.03). EBSLN which demonstrated a >25 % decreased amplitude in S2 increased significantly from Type 1 (4.9 %) to Type 2A (11.2 %) and 2B (18 %) (p = 0.01). None of type 1, 2.8 % type 2A and 3 % type 2B showed a loss of EBSLN conductivity. The latency determinations did not vary significantly for any parameter compared.
conclusionsThe Cernea classification was, therefore, found to predict the risk of EBSLN stress. We identified amplitude differences between S1 and S2 determinations in type 2A and 2B, thus confirming that surgical dissection in these subtypes is, therefore, extremely difficult to perform.
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