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Published in: Surgery Today 2/2013

01-02-2013 | How to Do It

The ima approach for the quick identification of the right recurrent laryngeal nerve in thyroid cancer surgery

Authors: Akira Miyauchi, Hiroo Masuoka, Tomonori Yabuta, Mitsuhiro Fukushima, Minoru Kihara, Takuya Higashiyama, Yuuki Takamura, Yasuhiro Ito, Kaoru Kobayashi, Akihiro Miya

Published in: Surgery Today | Issue 2/2013

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Abstract

Background

The right recurrent laryngeal nerve (RLN) is more difficult to identify than the left RLN. The superior, lateral and inferior approaches are currently used to identify the RLN. This report presents a new technique, called the ima approach (the most inferior approach) for the quick identification of the right RLN.

Methods

The ima approach involves dissection along the right common carotid artery and division of the most lateral branch of the inferior thyroid veins. The right RLN is identified at the bottom of the RLN triangle. This technique and the conventional inferior approach were applied to 81 and 19 patients with thyroid cancer, respectively.

Results

The ima approach required a significantly shorter time in identifying the nerve than the inferior approach (9.6 ± 16.6 and 31.2 ± 24.4 s, respectively, p < 0.0001).

Conclusion

The ima approach is an easy, quick and safe technique for identifying the right RLN.
Literature
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go back to reference Randolph GW. Surgical anatomy of the recurrent laryngeal nerve. In: Randolph GW, editor. Surgery of the thyroid and parathyroid glands. Philadelphia: Sounders; 2003. p. 300–2. Randolph GW. Surgical anatomy of the recurrent laryngeal nerve. In: Randolph GW, editor. Surgery of the thyroid and parathyroid glands. Philadelphia: Sounders; 2003. p. 300–2.
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go back to reference Randolph GW. Surgical anatomy, intraoperative neural monitoring, and operative management of the RLN and SLN. In: Duh QY, Clark OH, Kebebew E, editors. Atlas of endocrine surgical techniques. Philadelphia: Saunders; 2010. p. 86–110. Randolph GW. Surgical anatomy, intraoperative neural monitoring, and operative management of the RLN and SLN. In: Duh QY, Clark OH, Kebebew E, editors. Atlas of endocrine surgical techniques. Philadelphia: Saunders; 2010. p. 86–110.
Metadata
Title
The ima approach for the quick identification of the right recurrent laryngeal nerve in thyroid cancer surgery
Authors
Akira Miyauchi
Hiroo Masuoka
Tomonori Yabuta
Mitsuhiro Fukushima
Minoru Kihara
Takuya Higashiyama
Yuuki Takamura
Yasuhiro Ito
Kaoru Kobayashi
Akihiro Miya
Publication date
01-02-2013
Publisher
Springer Japan
Published in
Surgery Today / Issue 2/2013
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-012-0236-3

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