43091
document
A prospective , randomized trial of nerve monitoring of the external branch of the superior laryngeal nerve during thyroidectomy under local/regional anesthesia and IV sedation . BACKGROUND The aim of this study was to assess the impact of the neuromonitoring of the external branch of the superior laryngeal nerve ( EBSLN ) on the voice quality after mini-incision thyroidectomy under local/regional anesthesia and intravenous sedation . METHODS Patients undergoing mini-incision thyroidectomy under local anesthesia were prospectively randomized for either nerve monitoring of the EBSLN ( group 1 ) or no nerve monitoring ( group 2 ) . Voice and swallowing assessment were obtained by using the Voice Handicap Index-10 ( VHI-10 ) and the Reflux Symptom Index questionnaires ( RSI ) before surgery and at 3 weeks and 3 months after surgery . RESULTS Recruitment led to 22 patients in group 1 and 25 patients in group 2 . The rate of visualized EBSLN was higher in group 1 ( 66 % vs 21 % ; P = .003 ) . Contrary to group 1 , in group 2 , the median total VHI-10 score was significantly higher 3 months after surgery ( P = .034 ) compared with preoperatively , indicating a subjective voice handicap . In both groups , there was no difference in median total RSI score before surgery or at 3 weeks and 3 months after surgery . CONCLUSION Nerve monitoring aids in the visualization of the EBSLN during mini-incision thyroidectomy under local/regional anesthesia and leads to an improvement in patient-assessed voice quality after surgery but does not impact swallowing .
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Intervention_Physical
thyroidectomy
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Intervention_Pharmacological
local/regional anesthesia and IV sedation
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Intervention_Physical
mini-incision thyroidectomy
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Intervention_Pharmacological
local/regional anesthesia and intravenous sedation
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Intervention_Surgical
mini-incision thyroidectomy under local anesthesia
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Intervention_Physical
nerve monitoring of the EBSLN
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Intervention_Physical
or no nerve monitoring
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Intervention_Surgical
mini-incision thyroidectomy
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Intervention_Pharmacological
local/regional anesthesia
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Outcome_Other
voice quality
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Outcome_Other
Voice
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Outcome_Other
swallowing
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Outcome_Other
Voice Handicap Index-10 ( VHI-10 )
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Outcome_Other
the Reflux Symptom Index questionnaires ( RSI )
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Outcome_Mental
rate of visualized EBSLN
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Outcome_Mental
median total VHI-10 score
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Outcome_Mental
median total RSI score
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Outcome_Physical
EBSLN
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Outcome_Other
voice quality
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Outcome_Physical
swallowing
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Participant_Condition
mini-incision thyroidectomy
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Participant_Condition
local anesthesia
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Participant_Sample-size
22
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Participant_Sample-size
25