Intraoperative identification of external branch of the superior laryngeal nerve

Purpose – modification of existing methods of intraoperative identification of external branch of the superior laryngeal nerve.Materials and methods. The research was conducted during surgery on 80 patients with thyroid surgical pathology, who were divided into 2 groups. All patients were obligatorily examined at all stages of treatment by ENT specialist using video laryngoskope-nothing abnormal about larynx was detected. Performance acoustic voice analysis and voice assessment using subjective scales of voice quality were identified. The method involves stimulation of certain tissues in the operating field via the pulse generator and by the reduction of the cricothyroid muscle EBSLN is visually identified. After identification of EBSLN the upper pole vessels of thyroid part are transected without damaging thyroid body itself.Results and discussion. All patients were divided into two groups. The first group consisted of patients for whom the identification of EBSLN at the time of surgery was performed with electro-neurostimulator. For the patients in the second group identification was conducted under visual control with stage transection and ligation of vessels of the upper pole of the thyroid.The groups were divided into subgroups based on anatomical variant of EBSLN. The total number of EBSLN damage signs in group I was 2.5% while in group II it made up 17.5%.Conclusions. Application of intraoperative identification methods of EBSLN allows to identify tissue structures in operating field while transecting the upper pole of thyroid and consequently ensures impossibilities of any specific post operation complications. The method is simple in its application, does not require special skills and significantly reduces the incidence of EBSLN injury.