ArticleSurgical endoscopy2021
Endoscopic thyroidectomy versus traditional open thyroidectomy for identification of the external branch of the superior laryngeal nerve.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 10 citations in OpenAlex.
- The clinical value and learning curve analysis of the modified areolar approach for endoscopic thyroidectomy.Surgical endoscopy · 2026Article
- 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
- No closure of the linea alba cervicalis reduces complications in endoscopic thyroidectomy.Scientific reports · 2025Article
- Patient satisfaction and operator proficiency in gasless transaxillary endoscopic thyroidectomy under IONM: a retrospective cohort study.Frontiers in endocrinology · 2024Article
- Endoscopic hemithyroidectomy plus prophylactic central neck dissection via breast approach versus gasless transaxillary approach in treating low-risk papillary thyroid cancer: a retrospective series.Updates in surgery · 2023Article
- Resecting a solitary cervical vagal nerve neurofibroma via endoscopic surgery: a case report.Gland surgery · 2021Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo explore the anatomical features of the external branch of the superior laryngeal nerve (EBSLN) and determine an effective approach for its preservation during endoscopic thyroidectomy (ET).
methodsFrom January 2017 to December 2018, a total of 405 consecutive patients with thyroid disease were retrospectively analyzed. These patients were divided into the ET group and the open thyroidectomy (OT) group according to the surgical approaches. There were 195 cases in the ET group including 43 males and 152 females, and 210 cases in the OT group including 65 males and 145 females. The dissection process of EBSLN, detection rate, distribution of identification methods of the EBSLN and rate of voice change were recorded.
resultsThere were 205 EBSLNs detected under direct vision in ET group for a detection rate of 88.0%, while 158 EBSLNs were detected under direct vision in OT group for a detection rate of 58.1%. But with the assistant of intraoperative neuromonitoring (IONM), the number of EBSLNs detected visually reached up to 220 in ET group and 226 in OT group, respectively, for a visual detection rate of 94.4% and 83.1%, respectively. There were significant difference in the rate of direct visual identification, total visual identification with IONM. Stratified risk estimation indicated that the tumor size and location were risk factors for the direct visual dissection of EBSLN. Stratified analysis by tumor size indicated that when tumor diameter was ≤ 4 cm, the incidence of vocal cord fatigue and total vocal changes in ET group was significantly lower than that in OT group.
conclusionsRecognition and exposure of the EBSLN can be facilitated by the magnification and focusing function of high-definition endoscopy and the advantage of a 30° variable angle. Full exposure of the sternothyroid-laryngeal triangle and fine dissection along the superior thyroid vessels is beneficial for recognizing the EBSLN.
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