Recurrent Laryngeal Nerve's Motor Function: Sometimes Motor Fibers May Also Be Located in The Posterior Branch

Study Overview
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Brief Summary
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The investigators hypothesized that, sometimes the posterior branch of the recurrent laryngeal nerve may also have motor function. The investigators aimed to evaluate motor function of the branches in the branching recurrent laryngeal nerves in this study.

Detailed Description
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This study group consisted of consecutive patients, undergoing thyroid and parathyroid surgery with IONM. Both anterior and posterior branches of the recurrent laryngeal nerves were assessed separately by both electromyography endotracheal tube for adduction and finger palpation for detection of laryngeal twitch due to posterior cricoarytenoid abduction. The recurrent laryngeal nerves having motor function only in the anterior branches were defined as group 1, whereas the nerves having motor function both in the anterior and posterior branches were as group 2.

Official Title
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Descriptive in Vivo Study of Evaluating the Motor Function of Recurrent Laryngeal Nerve's Extralaryngeal Branching Electromyographically.

Conditions
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Recurrent Laryngeal Nerve Injuries

Intervention / Treatment
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* Device: intraoperative neuromonitoring


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who underwent parathyroid/thyroid surgery with intraoperative neuromonitoring , Patients who had normal vocal cord functions preoperatively. - Exclusion Criteria: Preoperative recurrent laryngeal nerve palsy, Intentional nerve transection because of cancer invasion, Assessment failure of recurrent laryngeal nerve function due to the deficiency of the intraoperative neuromonitoring equipment,. Parathyroidectomy operations that recurrent laryngeal nerves were not fully dissected. -

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group 1<br>The RLNs having motor function on the anterior branch assessed by intraoperative neuromonitoring. | Device: intraoperative neuromonitoring<br>* NIM-Response 3.0 Intraoperative Neuromonitoring System (Medtronic Xomed, Jacksonville, FL, USA) was used to record the EMG amplitude signal for the anterior and/or posterior branches of recurrent laryngeal nerves (RLNs).<br>|
| Active Comparator: Group 2<br>RLNs having motor function on anterior and posterior branch assessed by intraoperative neuromonitoring. | Device: intraoperative neuromonitoring<br>* NIM-Response 3.0 Intraoperative Neuromonitoring System (Medtronic Xomed, Jacksonville, FL, USA) was used to record the EMG amplitude signal for the anterior and/or posterior branches of recurrent laryngeal nerves (RLNs).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The evoked EMG potentials of the branches of the recurrent laryngeal nerves as microvolt, by intraoperative neuromonitoring. | The nerves , due to having motor functions whether on their anterior or posterior branches, were divided into two groups. The amplitudes of the anterior and posterior branches within the group 2 were compared. | intraoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The diameters of the branches of the recurrent laryngeal nerves. | The branch diameters of the recurrent laryngeal nerves were compared between the two groups. | intraoperative | 
| The branching distances of the recurrent laryngeal nerves. | The branching distances of the recurrent laryngeal nerves till the entry point into the larynx, were compared between the two groups. | intraoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Motor function of the extralaryngeal branches, intraoperative neuromonitoring, recurrent laryngeal nerve