Comparative study of different operative approachs for the treatment of upper thyroid gland / 中国实用外科杂志

OBJECTIVE: To explore the feasibility of different operative approaches for the treatment of upper thyroid gland. METHODS: The clinical data of 87 patients underwent lobectomy in Department of Oncological Surgery, the First Affiliated Hospital of Bengbu Medical College from January 2016 to December 2018 were analyzed retrospectively.Preoperative ultrasound was used to evaluate the location of the tumor in the upper thyroid gland or thyroid gland hypertrophy.According to the operative approach,87 cases were divided into two groups including 42 cases of the cricothyroid approach and 45 cases of viacervical strap muscles approach. The intraoperative exposure of superior laryngeal nerve and postoperative complications of superior laryngeal nerve function and parathyroid gland were compared. RESULTS: Compared with the superior laryngeal nerve finding rate(83.3%)in the cricothyroid approach,the superior laryngeal nerve finding rate was higher(95.6%)(P0.05). CONCLUSION: The viacervical strap muscles approach compares the cricothyroid approach to the laryngeal nerve with a high rate of finding and a short searching time. Applying viacervical strap muscles approach in the case of an upper thyroid tumor and glandular hypertrophy helps to expose the upper pole and protect the external nerve branch of the larynx.

Technical Review of How to Determine the Exact Location of Needle Tip During Office-Based Injection Augmentation of the Vocal Folds Via Cricothyroid Approach

The office-based, un-sedated vocal fold injection laryngoplasty has re-emerged in the past decade as an appealing alternative to microsuspension laryngoscopic procedure which is conducted under general anesthesia. The trend toward vocal fold injection laryngoplasty in an in-office setting was possible due to technological evolution for visualization and new injection materials. However, invisibility of the injection needle has been the main shortcomings of cricothyroid approach. The purpose of this review is to provide an up-to-date review of office-based, trans-cricothyroid membrane approach injection laryngoplasty technique under local anesthesia and efforts made to increase the preciseness of amount and location of the injected materials in the management of glottic insufficiency. A review of variable efforts undertaken to maximize the result of cricothyroid approach by technically increasing accuracy of the location of needle tip was done. With the proper patient selection and utilization of the new technologies, office-based and un-sedated vocal fold injection laryngoplasty via cricothyroid approach can be redeem as a main-stay in the management of glottic insufficiency, such as vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar.