Evidence map›Paper›PMID 38935142›Full record

ArticleLangenbeck's archives of surgery2024

The relation of recurrent laryngeal nerve to inferior thyroid artery and extralaryngeal nerve branching may increase the risk of vocal cord paralysis in thyroidectomy.

Nurcihan Aygun, Mehmet Taner Unlu, Ozan Caliskan, Mehmet Kostek, Adnan Isgor, Mehmet Uludag

Abstract read
In one paragraph

Article in Langenbeck's archives of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Nurcihan AygunDepartment of General Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Huzur Avenue, Cumhuriyet Street, Sariyer, Istanbul, 34371, Turkey. nurcihanaygun@hotmail.com.ORCID http://orcid.org/0000-0002-7353-8245
Mehmet Taner UnluDepartment of General Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Huzur Avenue, Cumhuriyet Street, Sariyer, Istanbul, 34371, Turkey.ORCID http://orcid.org/0000-0002-3487-609X
Ozan CaliskanDepartment of General Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Huzur Avenue, Cumhuriyet Street, Sariyer, Istanbul, 34371, Turkey.ORCID http://orcid.org/0000-0003-0408-2392
Mehmet KostekDepartment of General Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Huzur Avenue, Cumhuriyet Street, Sariyer, Istanbul, 34371, Turkey.ORCID http://orcid.org/0000-0001-7259-2461
Adnan IsgorDepartment of General Surgery, Sisli Memorial Hospital, Istanbul, Turkey.ORCID http://orcid.org/0000-0002-9117-7770
Mehmet UludagDepartment of General Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Huzur Avenue, Cumhuriyet Street, Sariyer, Istanbul, 34371, Turkey.ORCID http://orcid.org/0000-0003-1826-1615

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe anatomical variations of the recurrent laryngeal nerve (RLN) are common during thyroidectomy. We aimed to evaluate the risk of RLN paralysis in case of its anatomical variations, retrospectively.

methodsThe patients with primary thyroidectomy between January 2016 and December 2019 were enrolled. The effect of age, gender, surgical intervention, neuromonitorisation type, central neck dissection, postoperative diagnosis, neck side, extralaryngeal branching, non-RLN, relation of RLN to inferior thyroid artery (ITA), grade of Zuckerkandl tubercle on vocal cord paralysis (VCP) were investigated.

resultsThis study enrolled 1070 neck sides. The extralaryngeal branching rate was 35.5%. 45.9% of RLNs were anterior and 44.5% were posterior to the ITA, and 9.6% were crossing between the branches of the ITA. The rate of total VCP was 4.8% (transient:4.5%, permanent: 0.3%). The rates of total and transient VCP were significantly higher in extralaryngeal branching nerves compared to nonbranching nerves (6.8% vs. 3.6%, p = 0.018; 6.8% vs. 3.2%, p = 0.006, respectively). Total VCP rates were 7.2%, 2.5%, and 2.9% in case of the RLN crossing anterior, posterior and between the branches of ITA, respectively (p = 0.003). The difference was also significant regarding the transient VCP rates (p = 0.004). Anterior crossing pattern increased the total and transient VCP rates 2.8 and 2.9 times, respectively.

conclusionRLN crossing ITA anteriorly and RLN branching are frequent anatomical variations increasing the risk of VCP in thyroidectomy that cannot be predicted preoperatively. This study is the first one reporting that the relationship between RLN and ITA increased the risk of VCP.

Indexed as

Recurrent Laryngeal NerveThyroidectomyThyroid GlandVocal Cord ParalysisAdolescentAdultAgedFemaleHumansMaleMiddle AgedPostoperative ComplicationsRecurrent Laryngeal Nerve InjuriesRetrospective StudiesRisk FactorsYoung AdultExtralaryngeal nerve branchingInferior thyroid arteryRecurrent laryngeal nerveThyroidectomyVocal cord paralysis

Identifiers

PMID38935142
PMCPMC11211155

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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.