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Öğe Abdominal cerrahi sonrası antiadeziv maddelerin etkinliklerinin karşılaştırılması(Deneysel çalışma)(Düzce Üniversitesi, 2012) Doğan, Sami; Günal, ÖmerAMAÇ: Antiadeziv maddelerden seprafilm, suprofilm, zeytinyağı ve zeytinyağı+Vit. E'nin etkilerinin karşılaştırılarak kopma kuvvetlerini ölçerek değerlendirmekGEREÇ VE YÖNTEM: 60 adet Sprague-Dawley Albino cinsi erkek ratlar onarlı altı gruba ayrıldılar. Ketamine-HCI'le uyutuldu. İnce-ıslak zımpara (A955RC220) ile çekum-anterioryüz ve sağ batınönduvar paryetalperiton abrazyon uygulandı. 1.Grup: (Sham) sadece segmentler dışarı çıkarıp bakıldı. 2.Grup: (Kontrol)%0,9NaCl intraperitoneal 3cc verildi. 3.Grup: (Sepra) Seprafilm 3x3cm travma alan üzerine ve travmatize batınönduvar arasında olacak şekilde yerleştirildi. 4.Grup: (Supro) Aynı şekilde suprofilm yerleştirildi. 5.Grup: (Z.yağı) intraperitoneal 3cc steril edilmiş zetyinyağı verildi. 6.Grup: (Zeytinyağı+Vit-E) intraperitoneal 3cc steril edilmiş zetyinyağı + 20mg vit-E verildi. Post-op 14.gün Ketamine-HCI overdoz ve eter inhalasyonuyla sakrifiye edildi. Beş bölgenin (insizyon yerine, batınönduvar travmatize alanı, omentum?çekuma, omentum diğer organlararası, bağırsaklararası) adezyonları değerlendirildi. Dinamometreyle adezyon kuvveti değerlendirildi. Adezyon alanı 2x3cm eksize edilerek histopatolojik değerlendirme yapıldı.BULGULAR: Adezyon sıklığı: Grup-I'de sadece insizyon yerine (1)%10'unda adezyon oldu, Grup-II'de insizyon yerine (5)%50 batınönduvarına (5)%50, Omentum-çekuma (9)%90, omentum diğer organlara (0)%0, bağırsaklararasında (5)%50 oldu.Grup-III'te batınönduvar ve bağırsaklararası (2)%20, insizyon yerine ve omentum-diğer organlara (0)%0, Omentum-çekum (10)%100. Grup-IV'te İnsizyon yerine ve batın önduvarına (2)%20, omentum-çekuma (6)%60, omentum-diğer organlara (5)%50, bağırsaklararası (0)%0. Grup-V'te İnsizyon yerine (3)%30 batınönduvarına (4)%40, omentum-çekuma (9)%90, omentum-diğer organlararası (4)%40, bağırsaklararası (1)%10 bulundu. Grup-VI'da insizyon yerine (3)%30, batınönduvarına (7)%70, omentum-çekum (8)%80, omentum-diğer organlararası (2)%20, bağırsaklararası adezyon olmadı.Grup-I'de evre-I(0,43Newton) Grup-II'de evre-IV(1,0540N), Grup-III'te evre-II(0,6370N), Grup-IV'te evre-II(0,5230N), Grup-V'te evre-III(0,7620N), Grup-VI'da evre-IV(1,3560N) bulundu. Bu ortalamalar arasında istatistiksel olarak anlamlı fark bulundu. P=0,001,(p<0. 05). Histopatolojik inceleme: GrupV-VI'da inflamasyonu azalttığı, kollejen yapımı, fibroblastik aktivite ve damar proliferasyonunu artırtığı bulundu.SONUÇ: Adezyonların kopma kuvveti ölçülerek objektif değerlendirme yapılabilir. Suprofilm'de seprafilm gibi antiadeziv olarak etkili ve kullanılabilir. Zeytinyağı ve vit-E'nin ise antiadeziv olarak kullanılması için daha çok çalışma yapılması gerekir. Zeytinyağı ve vit-E antiadeziv olarak değilde, yara iyileşmesi bakımından faydalı görüldü.Öğe Abdominal pain due to hereditary angioedema: Case Report [Herediter anjiyoödeme ba?li karin a?risi](2012) Turan, Hakan; Beşir, Fahri Halit; Büyükkaya, Ramazan; Yaşar, Mehmet; Doğan, SamiHereditary angioedema is a disease characterized by subcutaneous edema without urticaria, upper airway obstruction, and gastrointestinal symptoms. It results from congenital deficiency of C1 esterase inhibitor. This rarely seen disease is autosomal dominant inherited, and severe forms can be life threatening. Here, we present a case of hereditary angioedema who applied to the emergency room with severe abdominal pain, with low levels of C1 esterase inhibitor and C4 and with specific ultrasound findings, and completely recovered with the application of C1 esterase inhibitor concentrate. Copyright © 2012 by Türkiye Klinikleri.Öğe Coexistence of Right Nonrecurrent Nerve and Bifurcated Recurrent Laryngeal Nerve Pointed by Zuckerkandl's Tubercle(Cureus Inc, 2017) Gürleyik, Emin; Doğan, Sami; Çetin, FuatThe recurrent laryngeal nerve (RLN) has many anatomical variations and various relations with adjacent structures. Identification and total exposure of the cervical part of the RLN was performed during operations on the thyroid gland. An extremely rare anatomical variation of the nerve was encountered during the surgical procedure. Coexistence of both right RLN and non-RLN was observed in one patient surgically treated with total thyroidectomy. We first exposed the right RLN with an extralaryngeal terminal bifurcation at its usual position. Thereafter, we also identified an ipsilateral non-RLN joining the anterior branch of the RLN just before laryngeal entry. A Zuckerkandl's tubercle has pointed out the junction of the two nerves. In this period, the incidence of coexistence of non-RLN and RLN was 0.2% in our series. A non-recurrent course is a rare anatomical variation of the inferior laryngeal nerve. The coexistence of both non-RLN and RLN is an extremely rare anatomical finding which should be taken into account during thyroid surgery.Öğe Comparing the Effects of Antiadhesıve Materials after Abdominal Surgery(2020) Doğan, Sami; Çetin, Mehmet Fuat; Günal, Ömer; Erdem, HavvaObjective: We aimed to evaluate and compare the effects of anti-adhesion materials,Seprafilm, Suprofilm, olive oil, and olive oil containing Vitamin E by measuring tensionforces.Methods: 60 male Wistar-Albino rats were divided into six groups. The front side of thececum and right abdominal parietal peritoneal wall were abrased. The rats wereeuthanized on the 14th postoperative day. Adhesions between intestines, omentum, otherabdominal organs, cecum, incisionsites, and abdominal anterior wall peritoneum were allevaluated. Adhesion strength was measured with dynamometer. Histopathologicalevaluations of the adhesion area was performed.Results: Stage-I (0.43Newton) in Group-I, stage-IV (1.0540N) in Group-II, stage-II(0.6370N) in Group-III, stage-II in Group-IV (0, 5230N), stage-III (0.7620N) in Group-V,stage-IV (1.3560N) in Group-VI, were detected. A significant difference was foundbetween these findings. P = 0.001, (p <0.05). Histopathological examination: It was foundthat GroupV-VI reduced inflammation, increased collagen production, fibroblastic activityand vascular proliferation.Conclusions: More objective evaluation can be made by measuring the tension force ofthe adhesions. Suprafilm can also be effectively used as an antiadhesive, such asSeprafilm. Olive oil and vitamin E require more studies to be used as antiadhesives.Öğe Discussion About Demographic Distribution And Surgery Technique Of Our Apendectomy Cases(Düzce Üniversitesi, 2016) Doğan, Sami; Çetin, Mehmet FuatIn this study we aimed to evaluate the outcomes of patients undergoing laparoscopic and openappendectomy with suspected appendicitis from August 2012 to August 2014.In this study data from 131 patients undergoing laparoscopic and open appendectomy betweenAugust 2012 and August 2014 in Van Training and Research Hospital were examinedretrospectively for demographic characteristics. In the laparoscopic appendectomy grouphandmade endoloop technique was used for closing the base of the appendix. Mc Burney’sincision was used for open appendectomy.47% of patients were female (n = 62), 53% of patients were male (n = 69). The average age ofthe patients was 27.7 years. According to surgical technique, open appendectomy was performed15% (n = 20), laparoscopic appendectomy was performed 85% (n = 110). For 3 patients,laparoscopic appendectomy was planned but then operation was converted to open techniquedue to device problems. PID has been detected in one patient who underwent diagnosticlaparoscopy so appendectomy was not performed. Postoperative drainage tube was placed to15% of patients (n = 20). Wound infection was seen in 4 open appendectomy performed patients(20%). Laparoscopic appendectomy was associated with a shorter hospital stay (2.2 days vs 2.8days). Laparoscopic appendectomy is as safe and efficient as open appendectomy in the treatment ofacute appendicitisÖğe Displacement of the Recurrent Laryngeal Nerve in Patients with Recurrent Goiter Undergoing Redo Thyroid Surgery(Hindawi Ltd, 2018) Gürleyik, Emin; Çetin, Fuat; Doğan, Sami; Yekenkurul, Erman; Önsal, Ufuk; Gürsoy, Fatih; İpor, AlperThyroid reoperations are surgically challenging because of scarring and disturbances in the anatomy of the recurrent laryngeal nerve (RLN). This study was conducted on 49 patients who underwent redo surgery. 61 RLNs were identified and completely exposed. Their functional integrity was evaluated using intraoperative nerve monitoring (IONM). Indications for secondary surgery, anatomical changes secondary to recurrent goiter mass and prior surgery, and results of IONM were studied. Frequent indications for redo surgery were multinodular goiter (MNG) in 19 (38.8%) and results of cytology in 14 (28.5%) patients. The mean time interval between primary and redo thyroid surgery was 23.4 years. We laterally approached 41 (67.2%) thyroid lobes between the sternocleidomastoid and sternohyoid muscles. 16 (26.2%) RLNs were found to be adherent to the lateral surface of the corresponding thyroid lobe. The functional integrity of all RLNs was confirmed by IONM. The remnant thyroid tissue can then lead to goiter recurrence requiring secondary surgery after a long period of time. The indications for redo surgery were similar to primary cases. Lateral displacement of the RLN which is adherent to the lateral surface of recurrent goiter mass is common anatomic variation. Thyroid reoperations based on awareness of anatomical disturbances can be performed safely by an experienced surgeon with support of ancillary electrophysiological technology.Öğe Does pregnancy interval after laparoscopic sleeve gastrectomy affect maternal and perinatal outcomes?(Taylor & Francis Ltd, 2019) Başbuğ, Alper; Kaya, Aşkı Ellibeş; Doğan, Sami; Pehlivan, Mevlüt; Göynümer, GökhanBackground: Obesity is a global health epidemic and is associated with many maternal and neonatal complications. Laparoscopic sleeve gastrectomy (LSG) is among the surgical treatments for obesity. The appropriate timing of pregnancy following LSG remains controversial and few studies have evaluated this public health issue. Objective: To evaluate the effect of pregnancy timing after LSG on maternal and perinatal outcomes. Study design: We performed a retrospective observational study of 23 pregnant women who underwent LSG at a tertiary hospital in Turkey. Women who became pregnant within 18 months of undergoing LSG were included in the early pregnancy after LSG group, and those who became pregnant after 18 months were included the late pregnancy after LSG group. Maternal and perinatal outcomes were evaluated, including gestational diabetes mellitus (GDM), pregnancy-associated hypertensive disorders, preterm birth, mode of delivery, small and large for gestational age births (small for gestational age (SGA), large for gestational age (LGA)), birth injury, and congenital malformations. Results: Body mass index (BMI) at conception was higher in the early pregnancy after LSG group than in the late pregnancy after LSG group (30.48 versus 27.25, respectively; p = .03). Pregnancy interval after LSG did not impact maternal-fetal complications or mode of delivery. After a 75 g oral glucose tolerance test (OGTT) for GDM, 75% (n = 6) of the early pregnancy group presented with early dumping syndrome, compared to only 13.3% (n = 2) of the late pregnancy after LSG group (p = .009). Conclusions: LSG may reduce obesity-related gestational complications, such as GDM and LGA. The interval between LSG and conception did not impact maternal or neonatal outcomes. Screening for GDM can result in dumping syndrome in pregnancies after LSG.Öğe Effect of melatonin on kidney cold ischemic preservation injury(E-Century Publishing Corp, 2013) Aslaner, Arif; Günal, Ömer; Turgut, Hamdi Taner; Çelik, Erdal; Yıldırım, Ümran; Demirci, Rojbin Karakoyun; Doğan, SamiMelatonin is a potent free radical scavenger of reactive oxygen species, nitric oxide synthase inhibitor and a well-known antioxidant secreted from pineal gland. This hormone has been reported to protect tissue from oxidative damage. In this study, we aim to investigate the effect of melatonin on kidney cold ischemia time when added to preservation solution. Thirty male Wistar albino rats were divided equally into three groups; Ringer Lactate (RL) solution, University of Wisconsin (UW) solution with and without melatonin. The serum Lactate Dehydrogenase (LDH) activities of the preservation solutions at 2nd, 24th, 36th, and 48th hours were determined. Tissue malondialdehyde (MDA) levels were also measured and a histological examination was performed at 48th hour. Melatonin that added to preservation solution prevented enzyme elevation and decreased lipid peroxidation in preservation solution when compared to the control group (p<0.05). The histological examination revealed that UW solution containing melatonin significantly prevented the kidney from pathological injury (p<0.05). Melatonin added to preservation solutions such as UW solution seemed to protect the tissue preserved effectively from cold ischemic injury for up to 48 hour.Öğe Effect of PEEP, Zero PEEP and Intraabdominal Pressure Levels on Cerebral Oxygenation in the Morbidly Obese Undergoing Sleeve Gastrectomy(Mary Ann Liebert, Inc, 2017) Yorulmaz, İlknur Suidiye; Demiraran, Yavuz; Salihoğlu, Ziya; Umutoğlu, Tarık; Özaydın, İsmet; Doğan, SamiThe study is designed to determine the effect of zero end expiratory pressure (ZEEP) and 5mmHg positive end expiratory pressure (5PEEP) on cerebral oxymeter (CO) levels in morbidly obese (MO) patients. Study was performed on 60 morbidly obese patients between 18-60 years old, American Society of Anesthesiology 2-3 status, scheduled to undergo laparoscopic sleeve gastrectomy under general anesthesia. The patients were divided into two groups: those ventilated with no PEEP (group ZEEP, n = 30) and those ventilated with 5 cmH(2)O PEEP levels (group 5PEEP, n = 28). rSO(2) values were measured. Data were recorded as basal, after the induction (A ind) of anesthesia, 5 min before insufflation (BI), 5 min after insufflation (AI), 15, 30, 45, and 60 min after induction, 5 min before desufflation, and 5 min after desufflation (AD). Invasive arterial pressures, CO values, peripheral oxygen saturation, end tidal carbondioxide, and intraabdominal pressure (IAP) were recorded in these time periods in all groups. Arterial blood samples were analyzed in terms of the 5BI, 5AI, and 5AD periods. There was a negative correlation between IAP and left CO on pneumoperitoneum time in group 5PEEP. Correlation was observed between bilateral CO values and ideal body weight (IBW), lean body weight (LBW), body surface area BSA, in group ZEEP. Correlation was observed between IBW, LBW, and right CO values in group 5PEEP. PEEP application may have a protective effect on cerebral oxygenation.Öğe Öğe Gastric squamous cell carcinoma: A case report [Gastrik skuamöz hücreli karsinom: Olgu sunumu](Duzce University Medical School, 2019) Gamsızkan, Mehmet; Torun, Serkan; Doğan, SamiGastric squamous cell carcinoma is rarely seen and affects mostly elder patients. A 78-year-old woman presented with nausea, vomiting, weight loss, and epigastric pain. There was an ulcero-vegetative mass in the posterior area from the large curvature to the antrum in the endoscopic examination. The gastroesophageal junction and cardia were also normal. We performed a diagnostic endoscopic biopsy. Histopathologically, it was composed of atypical squamous cells displaying infiltrating solid nests in a desmoplastic stroma. Immunohistochemically, the neoplastic cells also showed positivity for p40 and p63 and negativity for CEA. Besides, there was no radiological evidence of metastasis from other organs. We herein presented a case of gastric squamous cell carcinoma and discussed its clinical and morphological features with the literature. © 2019, Duzce University Medical School. All rights reserved.Öğe Inverse 'D' incision technique in treatment of pilonidal sinus disease; excision with minimal tissue loss, closure without tension and lateral location of the suture line(Korean Surgical Society, 2019) Doğan, Sami; Çetin, Fuat; Gürleyik, EminPurpose: Surgical excision is the preferred treatment modality for sacrococcygeal pilonidal sinus (PS). Notably, the desirable features of an ideal surgical intervention are excision with minimal tissue loss, closure without tension, and a lateral suture line. The present study aimed to investigate early outcomes of surgical excision through the inverse D ((sic)) incision based on tissue loss, wound tension, and suture line location. Methods: This prospective study was comprised of 80 patients with PS in whom excision of PS was performed through the '(sic).' incision to minimize tissue loss with a tensionless primary surgical wound closure. The suture line was located laterally in all patients. Early and late postoperative complications, duration of hospital stay, return to work, and recurrence rates were investigated. The mean duration of the follow-up period was 36 months. Results: Sixty-three patients (78.8%) were male. PS in all patients was surgically removed by subcutaneous excision through a '(sic).' incision. Laterally placed surgical wounds were closed primarily with interrupted vertical mattress sutures. No general complications were encountered. Five patients (6.3%) experienced early postoperative surgical site complications. On average, the duration of hospital stay and return to work were 2.4 days and 3.8 days, respectively. Recurrence was seen in 1 case (1.3%) during the follow-up period. Satisfaction score was high in 83.8% of patients. Conclusion: The method of sinus excision using the '(sic).' incision with a primary suture facilitates excision with minimal tissue loss and closure without tension with an off-midline suture. It is both a simple and effective surgical technique for the treatment of sacrococcygeal PS.Öğe Ocular abnormalities in morbid obesity(Consel Brasil Oftalmologia, 2019) Teberik, Kuddusi; Eski, Mehmet Tahir; Doğan, Sami; Pehlivan, Mevlüt; Kaya, MuratPurpose:Obesity is associated with eye diseases, but the underlying structural changes and pathogenic mechanisms have not been examined in detail. Here, we assessed the effects of morbid obesity on the morphometric indices of eye disease. Methods: Morbidly obese volunteers (n=101, body mass index [BMI] >= 40) and healthy individuals (n=95, BMI: 18.50-24.99) were examined by Goldman applanation tonometry, pachymetry, and spectral domain optical coherence tomography. Intraocular pressure, anterior chamber depth, axial length, central corneal thickness, retinal nerve fiber layer thickness, central fovea! thickness, and choroidal thickness were compared between groups. Results: Uncorrected intraocular pressure was significantly greater in the morbidly obese group than in the healthy control group (15.5 +/- 2.5 vs. 14.5 +/- 2.6 mmHg, p=0.009), whereas axial length, anterior chamber depth, and central corneal thickness did not differ between the groups. The mean retinal nerve fiber layer thickness at the temporal quadrant was reduced in the morbidly obese group (72.7 +/- 13.6 vs. 85.05 +/- 52.6 mu m, p=0.024). Similarly, the mean retinal thicknesses at nasal and temporal 1500-mu m locations were lower in the morbidly obese group (346.6 +/- 18.2 vs. 353.7 +/- 18.8 mu m, p=0.008; 323.1 +/- 20.3 vs. 330.0 +/- 18.9 mu m, p=0.001). The mean choroidal thickness was also reduced in almost all measurement locations (fovea, temporal 500 and 1000 mu m, and nasal 500, 1000, and 1500 mu m) of the obese group (p <0.05). Weight and BMI were negatively correlated with subfoveal choroidal thickness (r=-0.186, p=0.009; r=-0.173, p=0.015). Conclusion: Morbid obesity is associated with elevated uncorrected intraocular pressure and signs of neuropathy and retinopathy. Obesity may thus increase the risks of glaucoma and glaucomatous optic neuropathy.Öğe The rare coincidence: Nonrecurrent laryngeal nerve pointed by a Zuckerkandl's tubercle(Hindawi Limited, 2012) Gürleyik, Emin; Doğan, Sami; Günal, Ömer; Pehlivan, MevlütThe safety of thyroid operations mainly depends on complete anatomical knowledge. Anatomical and embryological variations of the inferior laryngeal nerve (ILN), of the thyroid gland itself and unusual relations between ILN and the gland threaten operation security are discussed. The patient with toxic multinodular goiter is treated with total thyroidectomy. During dissection of the right lobe, the right ILN which has nonrecurrent course arising directly from cervical vagus nerve is identified and fully isolated until its laryngeal entry. At the operation, we observe bilateral Zuckerkandl's tubercles (ZTs) as posterior extension of both lateral lobes. The left ILN has usual recurrent course in the trachea-esophageal groove. The right ZT is placed between upper and middle third of the lobe points the nonrecurrent ILN. The coincidence of non-recurrent ILN pointed by a ZT is rare anatomical and embryological feature of this case. Based on anatomical and embryological variations, we suggest identification and full exposure of ILN before attempting excision of adjacent structures, like the ZT which has surgical importance for completeness of thyroidectomy. © Copyright 2012 Emin Gurleyik et al.Öğe Recurrent Breast Abscess Caused by Corynebacterium amycolatum: A Case Report(Tubitak Scientific & Technical Research Council Turkey, 2009) Özaydın, İsmet; Yıldırım, Mustafa; Şahin, İdris; Doğan, SamiCorynebacterium species are an uncommon cause of breast abscess, and Corynebacterium amycolatum is rarely described in the literature. In the present case, we report recurrent breast abscess caused by C. amycolatum in a 39-year-old patient with normal immune function. Pathological diagnosis was granulomatous mastitis. The patient was treated with incision and drainage and ampicillin-sulbactam treatment. To our knowledge, this is the second report of breast abscess caused by C. amycolatum.Öğe Toxic Adenoma in a Patient with Thyroid Hemiagenesis(Cureus Inc, 2017) Gürleyik, Emin; Doğan, Sami; Çetin, Fuat; Gürsoy, Fatih; İpor, Alper MuratThyroid hemiagenesis (TH) is a rare congenital anomaly that is usually asymptomatic. Functional disorders of the thyroid make the patient symptomatic. TH is usually and incidentally established during evaluation of patients with symptomatic thyroid pathology. We report the case of a patient of TH who became symptomatic with hyperactivity of the gland. The patient presented with signs and symptoms of thyrotoxicosis. Physical examination revealed asymmetric nodular goiter at the right lobe. Biochemical analysis established the diagnosis of hyperthyroidism. Ultrasound of the thyroid gland revealed the absence of the left lobe and a large, solitary hypoechoic solid nodule in the right lobe. Nuclear scan showed the absence of the left lobe and revealed a large, autonomous solitary nodule in the right lobe. The diagnosis was a toxic adenoma. After medical control of hyperthyroidism, the patient was surgically treated with hemithyroidectomy. We prescribed postoperative replacement medication with L-thyroxin. Hyperthyroidism makes TH cases symptomatic. Thyroid ultrasound and scintigraphy incidentally discover agenesis of one lobe during evaluation of thyrotoxicosis. Hemithyroidectomy, including the autonomous nodule, is the procedure of choice for patients with toxic adenoma. Hemithyroidectomy in TH cases technically becomes a total thyroidectomy with a need for postoperative thyroid replacement therapy.Öğe Visual and electrophysiological identification of the external branch of superior laryngeal nerve in redo thyroid surgery compared with primary thyroid surgery(Korean Surgical Society, 2019) Gürleyik, Emin; Doğan, Sami; Çetin, Fuat; Gürleyik, GünayPurpose: Thyroid reoperations are surgically challenging because of significant anatomical variance. Visual and functional identification of the external branch of the superior laryngeal nerve (EBSLN) were studied in 2 groups of patients who underwent primary and redo thyroid surgery. Methods: This study was conducted on 200 patients: 100 patients with redo and 100 patients with primary thyroid surgery. In addition to visual identification, nerve branches were functionally identified by intraoperative nerve monitoring (IONM). Visual, functional, and total identification rates of the EBSLN in both primary and redo surgery were determined and compared between the 2 groups. Results: We attempted to identify 138 and 170 EBSLNs at risk in redo and primary surgery, respectively. Visual identification rates were 65.3% and 30.4% (P < 0.001) in primary and redo surgery groups, respectively. In total, 164 (96.5%) and 97 EBSLNs (70.3%) were identified in primary and redo surgery, respectively (P < 0.001), including the use of IONM. In primary surgery group, 53 nonvisualized EBSLNs of 164 identified nerves (32.3%) were determined by IONM alone. In redo surgery group, 55 of 97 identified nerves (56.7%) were determined by IONM alone (P < 0.001). Conclusion: Both visual and total identification rates of the EBSLN are significantly decreased in reoperative thyroidectomy. IONM increases the total identification rate of the EBSLN in primary and redo thyroid surgery. Electrophysiological monitoring makes a substantial contribution to the identification of the EBSLN both in primary and especially in redo thyroid surgery.
