SynthesisLangenbeck's archives of surgery2018
Surgical anatomy of the external branch of the superior laryngeal nerve: a systematic review and meta-analysis.
Synthesis in Langenbeck's archives of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer.Thyroid : official journal of the American Thyroid Association · 2025Guideline
- The superior thyroid artery origin pattern: a systematic review with meta-analysis.Surgical and radiologic anatomy : SRA · 2024Pooled it
- 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
- Complications After Thyroidectomy in Children: Lymph Node Dissection Is a Risk Factor for Permanent Hypocalcemia.Frontiers in endocrinology · 2021Trial
- Intraoperative neuromonitoring for preservation of the external branch of the superior laryngeal nerve in transoral endoscopic thyroidectomy: initial experience from Vietnam.Frontiers in surgery · 2026Article
- Article
- Incidence of Injury to External Branch of Superior Laryngeal Nerve as Diagnosed by Acoustic Voice Analysis After Thyroidectomy.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2025Article
- Revisiting Loré's retrograde thyroidectomy from the perspective of preserving the external branch of the superior laryngeal nerve.Gland surgery · 2023Article
- Intraoperative cricothyroid muscle electromyography may contribute to the monitorization of the external branch of the superior laryngeal nerve during thyroidectomy.Frontiers in endocrinology · 2023Article
- Utility of video-assisted method for identifying and preserving the external branch of the superior laryngeal nerve during thyroidectomy.Frontiers in surgery · 2023Article
- Analysis of Risk Factors for Phonation Disorders after Thyroid Surgery.Biomedicines · 2022Article
- Intraoperative Neuromonitoring, Nerves at Risk and Staged Thyroidectomy, our Experience on 377 Consecutive Cases.Acta bio-medica : Atenei Parmensis · 2022Article
- Seeing Is Not Believing: Intraoperative Nerve Monitoring (IONM) in the Thyroid Surgery.Indian journal of surgical oncology · 2022Review
- 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
- The Superior Laryngeal Nerve and Its Vulnerability in Surgeries of the Neck.Diagnostics (Basel, Switzerland) · 2021Article
- Unmapped landmarks around branches of the Superior Laryngeal Nerve: An exploratory cadaveric study.Journal of Taibah University Medical Sciences · 2021Article
- Narrative review of management of thyroid surgery complications.Gland surgery · 2021Review
- Selective vagus-recurrent laryngeal nerve anastomosis in thyroidectomy with cancer invasion or iatrogenic transection.Langenbeck's archives of surgery · 2020Article
- Functional vagotopy in the cervical vagus nerve of the domestic pig: implications for the study of vagus nerve stimulation.Journal of neural engineering · 2020Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo provide a comprehensive evidence-based assessment of the anatomical characteristics of the external branch of the superior laryngeal nerve (EBSLN). MATERIALS AND
methodsA thorough systematic search was performed on the major electronic databases PubMed, EMBASE, Cochrane library, and ScienceDirect to identify eligible studies. Data were extracted and pooled into a meta-analysis. The primary outcomes were the EBSLN identification rate (total number of EBSLN identified divided by the total number of dissected hemilarynges) and the prevalence of various EBSLN types.
resultsA total of 56 studies (n = 13,444 hemilarynges) were included. The overall pooled EBSLN identification rate was 89.24% (95% CI 85.49-92.49). This rate was higher for cadaveric (95.00%; 95% CI 89.73-99.35) compared to that reported in intraoperative studies (86.99%; 95% CI 82.37-91.01). Significantly higher identification rates were reported for studies in which intraoperative nerve monitoring was used (95.90%; 95% CI 94.30-97.25) compared to those which only relied on direct visual identification of the EBSLN (76.56%; 95% CI 69.34-83.08). Overall, Cernea type IIa (nerves crossing the superior thyroid artery less than 1 cm above the upper edge of the superior thyroid pole) and Friedman type 1 (nerves running their entire course superficial to the inferior pharyngeal constrictor) were the most prevalent (41.84%; 95% CI 33.28-48.08 and 50%; 95% CI 29.90-65.62, respectively). The combined prevalence of Cernea IIa and IIb (nerves crossing the superior thyroid artery below the upper edge of the superior thyroid pole) was higher in intraoperative studies compared to that in cadaveric studies (64.3% vs 49.4%). The EBSLN coursed medial to the superior thyroid artery in 70.98% (95% CI 55.14-84.68) of all cases.
conclusionThe use of intraoperative nerve monitoring improves EBSLN identification rates. In light of the highly variable anatomical patterns displayed by the EBSLN, thorough pre-operative knowledge of its anatomy can be crucial in minimizing incidences of its iatrogenic injury.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.