Resumen

LUCENA OLAVARRIETA, Jorge Ramón; CORONEL, Paúl  y  USECHE IZARRA, César. El nervio laríngeo superior en la cirugía del tiroides: Estudio experimental en el perro. Rev. venez. oncol. [online]. 2009, vol.21, n.3, pp.132-137. ISSN 0798-0582.

OBJECTIVE: Injury to external branch of superior laryngeal nerve during thyroid surgery can have serious consequences. METHOD: A strategy for perioperative identification and preservation of the superior laryngeal nerve was evaluated by experimental study in 30 adult mongrel dogs model weighing 45 to 55 pounds were used after approval by the animal studies committee at the Central University School of Medicine. RESULTS: These showed that 20 % of external branch of the superior laryngeal nerve run distally through the pharyngeal constrictor muscle, which necessitates intramuscular dissection for identification in the area around the superior thyroid pole. In 23 % of external branch of the superior laryngeal nerve identifiable without intramuscular dissection, a course partly lateral to the superior thyroid artery its branches implied definitive risk of injury during division of the superior pole vessels. 72 % of the external branch of the superior laryngeal nerve was identifiable without intramuscular dissection, and 19 % of these were lateral partly to the superior thyroid artery. Only one patient had signs of external branch of the superior laryngeal nerve injury postoperatively, probably caused by diathermy to an adjacent vessel. CONCLUSION: Perioperative identification of external branch of the superior laryngeal nerve with dissection into the pharyngeal constrictor muscle appears to be inadvisable, but identification of external branch of the superior laryngeal nerve with other courses is important, as around 20 % are highly vulnerable during division of the superior thyroid artery and its branches.

Palabras clave : Surgery; nerve; laryngeal superior; thyroid; superior thyroid artery; dissection.