Comparison of effects of energy based devices on quality of life after sutureless thyroidectomy

Objective: In current literature, no studies evaluated effect of energy-based vessel-sealing-devices on quality of life after sutureless total thyroidectomies. This study aimed to identify any potential differences between two energy-based vessel-sealing-devices (Harmonic Focus, Ligasure LF1212) in patients with benign thyroid disorders who underwent sutureless total thyroidectomy. Materials and methods: Differences in quality of life of patients were evaluated using data obtained by Thy-PRO-39-Tr questionnaire prior to and four-week after surgery. Total and domain-based alterations in quality of life were compared between groups according to energy-based vessel-sealing-devices type (Group L, Group H). Additionally, data including demographics, height, weight, body mass index, neck circumference, sternomental distance were collected. Results: Of 1032 patients, 200 were eligible for study, at the end 193 were analysed. There were no differences between groups in terms of age, sex, body mass index, tobacco use. Analysis did not reveal any differences in overall quality of life between groups (P = .42). However, in "eye symptoms" (P < .001) and "cognitive functions" (P = .002) domains, Harmonic provided statistically improved quality of life. Effect on cognitive function was greater in patients of advanced age. Conclusions: Especially in elderly patients with worsening eye conditions and cognitive functions, use of Harmonic may enhance patients' outcome by increasing quality of life in addition to optimizing surgical outcome when compared to Ligasure

A rare case of non-surgical vocal cord paralysis: Vocal cord hematoma

Although vocal cord paralysis (VCP) following thyroidectomy is primarily associated with surgical trauma, it is not the sole etiology. Vocal cord paralysis following thyroidectomy can be caused by a vocal cord hematoma with an incidence of 1.4% due to direct injury during orotracheal intubation. In this article, we present a case of VCP caused by vocal cord hematoma. A 32-year-old male patient who has been receiving propylthiouracil treatment for toxic multinodular goiter since 10 years was admitted to our hospital to be operated because of persisting complaints. The patient was hospitalized for sutureless thyroidectomy after he became euthyroid. Preoperative fiberoptic laryngoscopy performed by the ear, nose, and throat department revealed bilaterally motile vocal folds and a completely open airway. Patient underwent sutureless total thyroidectomy with a vessel sealing device (Ligasure (TM) LF1212, Covidien, CO), and a minivac drainage system was placed in the thyroid lodge. On the morning of the first postoperative day, 50 mL of serosanguinous fluid was drained. The patient's voice was normal, and there was no ecchymosis. Postoperative fiberoptic laryngoscopy revealed a hematoma near the right vocal fold and paralysis of the right vocal fold; however, the airway was open. It should be kept in mind that VCP is not solely due to surgery but can also result from intubation, as observed in this case

Is Nerve Monitoring Required in Total Thyroidectomy? Cerrahpasa Experience

Thyroidectomy is an elective operation performed in an anatomically complex region in which certain structures are responsible for vital functions and special senses. This study aims to compare the effects of two different technical approaches-nerve dissection combined with intraoperative nerve monitoring (IONM) and no nerve identification-on recurrent laryngeal nerve (RLN) damage in total thyroidectomy. One hundred and sixty-one consecutive cases that underwent total thyroidectomy and 322 RLN under risk were evaluated. In group 1 (n=162), nerve dissection combined with IONM was performed, whereas no RLN identification was performed in group 2 (n=160). While the duration of operation in group 1 (34.23 +/- 12.21 min) was statistically shorter than that in group 2 (36.98 +/- 16.79 min, p=0.017), there was no significant difference between groups related to RLN palsy (group 1 n=10, group 2 n=7). Use of IONM was found only to shorten the duration of operation. According to our presented experience, there is no benefit of IONM-combined routine dissection of RLN during total thyroidectomy on the prevention of RLN palsy

REOPERATIONS AND MORBIDITY IN THYROID SURGERY

Objective: Due to adhesions and distorted anatomy resulting from previous operations, reoperations are associated with increased complication rates. This study aims evaluate the morbidity in reoperative thyroid surgery

EFFECT OF TOTAL THYROIDECTOMY ON MORTALITY AND MORBIDITY IN GERIATRIC PATIENTS: CERRAHPASA EXPERIENCE

Introduction: The purpose of this study is to confirm safety of total thyroidectomy and to investigate the effect of age on potential mortality and morbidity in geriatric patients