Role of Stroboscope in Injury of External Branch of Superior Laryngeal Nerve During Thyroid Surgery
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ORIGINAL ARTICLE
Role of Stroboscope in Injury of External Branch of Superior Laryngeal Nerve During Thyroid Surgery Ramkumar Vellikkannu1 • Deepakraj Venkatesan1 Preethi Umamaheswaran1 • Sriram Ramamurthy3
•
Vipin Ram Ekhar2
•
Received: 15 September 2020 / Accepted: 16 October 2020 Ó Association of Otolaryngologists of India 2020
Abstract Role of stroboscope in injury of External branch of superior laryngeal nerve during thyroid surgery. Study conducted in a tertiary care hospital. 40 patients were selected and divided into two groups as Group A and B. Benign thyroid swellings were included, excluding preoperative vocal cord pathology by performing videolaryngoscope and videostroboscope. After thyroidectomy procedure stroboscopic fundamental frequency, symmetry, periodicity, glottic closure and mucosal wave pattern were assessed in both the groups and compared. The mean difference in fundamental frequency between pre operative and postoperative in Group A was 37.85 (SD = 33.69) and in Group B was 58.40 (SD = 77.55) with p-value of 0.287. Symmetry of cords in Group A was 90% and asymmetry was 10%, while in Group B symmetry of cords was 75%
and asymmetry of 25% with p-value of 0.407. Other parameters like regular periodicity, complete glottic closure, normal mucosal pattern was 95% in Group A and 75% in Group B. Irregular periodicity, incomplete glottis closure, decreased mucosal wave pattern was 5% in Group A and 25% in Group B. Stroboscope is an essential and useful tool in diagnosing EBSLN injury. It is useful in assessing pre operative voice assessment before and after thyroid surgery than a video laryngoscope.
& Ramkumar Vellikkannu [email protected]
Thyroidectomy is most common surgical procedure performed in Otorhinolaryngoloy. Major concern in thyroid surgery is morbidity due to injury to anatomical structures [1]. The important structures that should be preserved during thyroid surgery are the Recurrent laryngeal nerve (RLN), Parathyroid glands and the External branch of superior laryngeal nerve (EBSLN) [2]. Numerous research works has been done on ways to preserve the RLN and parathyroid glands, less attention were given to EBSLN [3]. In fact it is described as a ‘neglected’ nerve in thyroid surgery; despite the fact that injury to this nerve can cause significant disability [4]. Unilateral injury to EBSLN may result in mild huskiness; however bilateral injury can result in devastating consequences. In most individuals, these changes tend to be a nuisance, but it can be catastrophic in voice professionals [5]. So voice after thyroidectomy surgeries is gaining importance recent days. A Stroboscope is a great diagnostic tool in diagnosing voice change in these patients. In recent days since the incidence of
Deepakraj Venkatesan [email protected] Vipin Ram Ekhar [email protected] Preethi Umamaheswaran [email protected] Sriram Ramamurthy [email protected] 1
Department of ENT, Head & Neck Surgery, Panimalar Medical College Hospital & Research Institute, Chennai, India
2
Depart
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