ArticleThyroid : official journal of the American Thyroid Association2016
Is the External Branch of the Superior Laryngeal Nerve Dispensable in Thyroid Surgery?
Article in Thyroid : official journal of the American Thyroid Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 16 citations in OpenAlex.
- Visual identification and neuromonitoring vs. no sighting the external branch of the superior laryngeal nerve in thyroid surgery: a randomized clinical trial.Updates in surgery · 2022Trial
- Unmapped landmarks around branches of the Superior Laryngeal Nerve: An exploratory cadaveric study.Journal of Taibah University Medical Sciences · 2021Article
- Endoscopic thyroidectomy versus traditional open thyroidectomy for identification of the external branch of the superior laryngeal nerve.Surgical endoscopy · 2021Article
- Anatomy of the external branch of the superior laryngeal nerve in Asian population.Scientific reports · 2017Article
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Authors and funding
3 authors at 1 institution in 1 country.
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Abstract
backgroundThere is growing evidence that the external branch of the superior laryngeal nerve (eSLN) participates in thyroarytenoid (TA) contraction, but little data quantify its role in vocal cord adduction. Injury to the eSLN, such as in thyroid surgery, is difficult to diagnose and likely underappreciated. It is the authors' belief that eSLN injury contributes to aspiration by depriving its contribution to the laryngeal plexus. The goal of this study was to measure the glottic closing force (GCF) from eSLN stimulation in a porcine model.
methodsThe recurrent laryngeal nerve (RLN) and eSLN were identified bilaterally in four porcine necks. Bilateral RLNs and eSLNs were stimulated simultaneously to obtain a control GCF using a pressure transducer placed in the glottis. Subsequently, bilateral eSLNs were stimulated and the GCF measured to quantify its percent contribution to the control value.
resultsStimulation of the RLNs and the eSLNs each led to TA muscle contraction and a measureable GCF in all four porcine necks. The control GCF was 1000.1 mmHg, while the eSLN mediated CGF was 800 mmHg. The percentage GCF attributable to the eSLN was thus 800/1000 = 80%.
conclusionsReflex glottic closure is one of the most important mechanisms for the prevention of aspiration during deglutition. The biomechanical quantification of glottic closure can be shown as the GCF. This study has shown that the eSLN contributes in a significant way to the GCF in a porcine model, a finding that has not been quantified to the best of the authors' knowledge. Therefore, greater focus should be placed on preserving this nerve in thyroid surgery.
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