The significance of preservation of the supraclavicular nerve in endoscopic thyroidectomy via gasless anterior chest approach
10.3760/cma.j.issn.1673-0860.2017.11.004
- VernacularTitle: 胸前入路免注气内镜甲状腺手术中锁骨上神经的保护价值
- Author:
Zhiwei ZHOU
1
;
Faya LIANG
1
;
Ping HAN
1
;
Peiliang LIN
1
;
Xiaoming HUANG
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
- Publication Type:Journal Article
- Keywords:
Endoscopes;
Thyroidectomy;
Sensation;
Anterior chest approach;
Supraclavicular nerve
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2017;52(11):819-823
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the significance for the preservation of the supraclavicular nerve in endoscopic thyroidectomy via gasless anterior chest approach.
Methods:We retrospectively evaluated 168 patients who underwent unilateral endoscopic thyroidectomy via gasless anterior chest approach, with preservation of the medial branch of the supraclavicular nerve in 110 patients and not in other 58 patients. Semmes-Weinstein monofilament (SWM) test and a visual analogue scale (VAS) were used to assess the recovery of sensation in anterior chest within 1-12 months postoperatively. Difference in the scores of SWM or VAS between groups was tested with Mann-Whitney U test, and the rates of SWM and VAS scores returning to normal levels in individual periods after surgery was compared with Chi-square test.
Results:The preserved group showed more favorable results than the non-preserved group in both SMW and VAS scores. Compared to control group, SWM score in preserved group possessed a higher rate recovery to normal level at any period after operation, which was close to complete normality in 7-9 months postoperatively, and SWM score in non-preserved group was still partially normal in 10-12 months from surgery. Preferable results for VAS were also found in the preserved group, except no significant difference in VAS between groups in1-3 months or 10-12 months after operation.
Conclusion:Preservation of the medial branch of the supraclavicular nerve in endoscopic thyroidectomy via gasless anterior chest approach can improve sensation recovery in anterior chest, thus improving postoperative quality of life of patients.
