Modification of anaesthetic technique for thyroidectomy with preservation of external laryngeal nerve to aid electrical stimulation

Abstract AR

Backgrounds: The external branch of the superior laryngeal nerve is a branch of the vagus nerve that innervates the cricothyroid muscle.

Contraction of the cricothyroid muscle tenses and elongates the vocal cords, so that its junction is of vital importance in certain professionals who need a high pitched voice.

The incidence of injury to this nerve during thyroid surgery is as high as 28% in all cases.

Methods: Forty patients undergoing thyroid surgery were enrolled in this study.

An intraoperative electrical nerve stimulator was used for nerve identification along with a modified anaesthetic technique.

The choice of muscle relaxant used was based on a review of the literature in order to determine which relaxant has no delayed effect.

Results: Preservation of this nerve was successful in this study in all 40 patients who underwent thyroidectomy or other thyroid surgery.

Using this method, none of the patients participating in this study showed anaesthetic complications, voice changes or cord abnormalities in the postoperative period.

Conclusion: Having had a 100% success rate to identify the nerve and preserve it, it is recommended that this method be used for every thyroidectomy, especially for huge goiters, and certainly for actors, professional lecturers and singers.