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Start date: 2020End date: 2026Has files: YesAuthor: search.filters.author.Aygün, NurcihanType: search.filters.itemtype.Article

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    PublicationOpen Access
    Intraoperative Neuromonitoring in Thyroid Surgery: An Efficient Tool to Avoid Bilateral Vocal Cord Palsy
    (SAGE Publications Ltd, 2021) Kartal, Kinyas; Aygün, Nurcihan; Celayir, Fevzi; Besler, Evren; Çitgez, Bülent; Işgör, Adnan; Uludaǧ, Mehmet; Kartal, Kinyas, Department of General Surgery, Koç Üniversitesi, Istanbul, Turkey; Aygün, Nurcihan, Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey; Celayir, Fevzi, Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey; Besler, Evren, Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey; Çitgez, Bülent, Department of General Surgery, University of Health Sciences, Istanbul, Turkey; Işgör, Adnan, Department of General Surgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Uludaǧ, Mehmet, Department of General Surgery, University of Health Sciences, Istanbul, Turkey
    Objectives: This study aimed to analyze the effects of intraoperative neuromonitoring (IONM) on the prevalence of vocal cord palsy (VCP) in thyroid surgery. Methods: Data from 493 patients (839 nerves at risk [NAR]) who underwent thyroid surgery between July 2014 and May 2016 were retrospectively evaluated. The patients were divided into 2 groups: Group 1 (G1) consisted of patients who underwent surgery without IONM, whereas group 2 (G2) consisted of patients who underwent surgery with IONM. The surgical techniques were identical, and experienced surgeons performed the procedures in both groups. Intraoperative neuromonitoring was performed in compliance with the International Neural Monitoring Guidelines. Results: In total, 211 patients (170 female, 41 male) with 360 NAR were included in G1, and 282 patients (220 female, 62 male) with 479 NAR were included in G2. The number of VCP per NAR in G1 and G2 was 33 (9.2%) and 27 (5.6%), respectively (P =.005). The number of transient VCP per NAR in G1 and G2 was 27 (7.5%) and 23 (4.8%, P =.230), respectively. The number of permanent VCP per NAR in G1 and G2 was 6 (1.7%) and 4 (0.8%, P =.341), respectively. Bilateral VCP was detected in 4 (2.7%) patients in G1, whereas there was no patient with bilateral VCP in G2 (P =.033). Conclusions: Intraoperative neuromonitoring may decrease the incidence of total VCP and prevent the development of bilateral VCP, which has unfavorable results for both patients and health-care professionals. © 2022 Elsevier B.V., All rights reserved.
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    PublicationOpen Access
    The effect of strap muscle transection on voice and swallowing changes after thyroidectomy in patients without laryngeal nerve injury
    (Royal College of Surgeons of England, 2022) Aygün, Nurcihan; Celayir, Fevzi; Işgör, Adnan; Uludaǧ, Mehmet; Aygün, Nurcihan, University of Health Sciences, Istanbul, Turkey; Celayir, Fevzi, University of Health Sciences, Istanbul, Turkey; Işgör, Adnan, Bahçeşehir Üniversitesi, Istanbul, Turkey; Uludaǧ, Mehmet, University of Health Sciences, Istanbul, Turkey
    Introduction Voice and swallowing symptoms are frequently reported after thyroidectomy even without laryngeal nerve injury. We aimed to evaluate the effect of strap muscle transection on voice and swallowing outcome after thyroidectomy. Methods Group 1 (G1) consisted of 17 patients who had their strap muscles transected during thyroidectomy and group 2 (G2) consisted of 17 patients who had their strap muscles preserved during thyroidectomy. None of the patients had laryngeal nerve injury. Voice impairment scores (VIS) and swallowing impairment scores (SIS) were obtained preoperatively and at 1 week and 1, 3 and 6 months postoperatively. Pre- and postoperative vocal cord examinations were performed for all patients. The external branch of the superior laryngeal nerve (EBSLN) was evaluated by intraoperative cricothyroid muscle electromyography. Results There was no significant difference in VIS and SIS between the two groups. At postoperative week 1, the VIS and SIS for each group were above preoperative values (G1: p = 0.005 and p = 0.035, G2: p = 0.031, p = 0.346, for VIS and SIS respectively). The VIS and SIS scores at 6 months postoperatively were significantly lower than those of the first week postoperatively (G1: p = 0.04 and p = 0.001, G2: p = 0.022 and p = 0.034 respectively) and similar to preoperative values (G1: p = 0.924 and p = 0.086, G2: p = 0.822 and p = 0.187 respectively). Conclusion Although voice and swallowing complaints increased in the early postoperative period even without recurrent laryngeal nerve and EBSLN injuries, these symptoms are not related with the strap muscle transection. © 2023 Elsevier B.V., All rights reserved.