Location of motor fibers within branches of the recurrent laryngeal nerve with extralaryngeal terminal bifurcation; Functional identification by intraoperative neuromonitoring

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dc.contributor.authorGürleyik, Emin
dc.date.accessioned2020-04-30T23:18:58Z
dc.date.available2020-04-30T23:18:58Z
dc.date.issued2015
dc.departmentDÜ, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümüen_US
dc.descriptionWOS: 000363005800021en_US
dc.descriptionPubMed: 26054316en_US
dc.description.abstractBackground. Extra laryngeal terminal bifurcation (ETB) of the recurrent laryngeal nerve (RLN) is an anatomic variation that threatens the safety of thyroid operation. Therefore, it is important to identify motor function in nerve branches to preserve appropriate motor activity. Intraoperative neuromonitoring (IONM) is an accepted procedure to identify motor function of the RLN. Methods. We established the operative anatomy of RLNs with ETB in 47 patients. The main trunk, bifurcation point, and the branches were identified and exposed completely during thyroid operation. The location of motor fibers within nerve branches was investigated by identifying motor function via IONM. Wave amplitudes were recorded after electrophysiologic stimulation. Results. A total of 61 RLNs had ETBs with anterior and posterior branches. Bifurcation occurred early along the pre-arterial (proximal) segment in 13% of bifid RLNs. IONM showed motor function in all anterior branches. IONM identified motor activity in 4 (18%) posterior branches of 22 right, 3 (8%) posterior branches of 39 left, and 7 (12%) posterior branches of all 61 RLNs with ETB. The rate of recorded wave amplitudes of motor function in seven posterior branches was between 14 and 78% of those of corresponding anterior branches. Conclusion. In the RLN, the anterior branch always and the posterior branch uncommonly contain motor fibers. Wave amplitude analysis showed that motor function in the posterior branch is weaker than that in the anterior branch. On the basis of the location of motor fibers in both branches, total exposure and preservation of anatomy and function of all branches of the RLN is mandatory for complication-free thyroid surgery. Electrophysiologic testing may be as an important adjunct to visualization of the nerve with anatomic variation.en_US
dc.description.sponsorshipDuzce University Scientific Research ProjectsDuzce University [DUBAP 2012.04.02.121]en_US
dc.description.sponsorshipThis study is based on the project supported by Duzce University Scientific Research Projects (Project No. DUBAP 2012.04.02.121).en_US
dc.identifier.doi10.1016/j.surg.2015.04.019en_US
dc.identifier.endpage1344en_US
dc.identifier.issn0039-6060
dc.identifier.issue5en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpage1339en_US
dc.identifier.urihttps://doi.org/10.1016/j.surg.2015.04.019
dc.identifier.urihttps://hdl.handle.net/20.500.12684/3603
dc.identifier.volume158en_US
dc.identifier.wosWOS:000363005800021en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherMosby-Elsevieren_US
dc.relation.ispartofSurgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.titleLocation of motor fibers within branches of the recurrent laryngeal nerve with extralaryngeal terminal bifurcation; Functional identification by intraoperative neuromonitoringen_US
dc.typeArticleen_US

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