Alkan Zeynep, Yigit Ozgur, Adatepe Turgut, Uzun Nurten, Kocak Ismail, Sunter Volkan, Server Ela Araz
Department of Otorhinolaryngology, Istanbul Training and Research Hospital, Istanbul, Turkey ; Department of Anatomy, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey ; Sıracevizler Cad Isık Apt No:116/3, Posta Kodu: 34381 Sisli, Istanbul.
Department of Otorhinolaryngology, Istanbul Training and Research Hospital, Istanbul, Turkey ; Department of Anatomy, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
Indian J Otolaryngol Head Neck Surg. 2014 Jan;66(Suppl 1):71-7. doi: 10.1007/s12070-011-0319-2. Epub 2011 Nov 5.
Impairment of laryngotracheal movement is a possible complication after total thyroidectomy. Here, we aimed to investigate the frequency and extent of impairment of laryngotracheal movement after total thyroidectomy and the effect of anti-adhesive barrier hyaluronic acid-carboxymethylcellulose membrane positioning between strap muscles and laryngotracheal complex on deglutition. The study design is prospective clinical study. Istanbul Training and Research Hospital, Laboratory of Electrophysiology, Istanbul Training and Research Hospital. The patients who underwent total thyroidectomy were selected and dichotomized according to use of seprafilm. Each group consisted of 8 female patients. All patients were assessed clinically and electrophysiologically in the pre/postop period. Electrophysiological investigations included cricopharyngeal muscle (CPM) electromyography (EMG), submental EMG, single bolus analysis [foreburst, reburst, swallowing (pause) patterns], laryngotracheal movement analysis and results were compared between two groups. CPM EMG was normal in both groups. Duration of submental muscle activity during dry and 15 cc water swallowing was similar between two groups (P = 0.751). Pause duration was shorter in group with seprafilm (P < 0.01). Dysphagia limit was 15 cc in both groups. The fore/rebound bursts duration, the time of laryngeal elevation, closure and suspension were similar (P = 0.954). We concluded that use of seprafilm between larynx and strap muscles during total thyroidectomy does not have any adverse effects on swallowing. Anti-adhesive barrier can be used safely during thyroid surgery.
喉气管运动障碍是全甲状腺切除术后可能出现的并发症。在此，我们旨在研究全甲状腺切除术后喉气管运动障碍的发生频率和程度，以及在带状肌与喉气管复合体之间放置抗粘连屏障透明质酸 - 羧甲基纤维素膜对吞咽的影响。本研究设计为前瞻性临床研究。伊斯坦布尔培训与研究医院，电生理实验室，伊斯坦布尔培训与研究医院。选取接受全甲状腺切除术的患者，并根据是否使用施沛特进行二分法分组。每组由8名女性患者组成。所有患者在术前/术后均进行临床和电生理评估。电生理检查包括环咽肌（CPM）肌电图（EMG）、颏下肌EMG、单次吞咽分析[前冲、再冲、吞咽（暂停）模式]、喉气管运动分析，并比较两组结果。两组CPM EMG均正常。两组在吞咽干燥物和15毫升水时颏下肌活动持续时间相似（P = 0.751）。使用施沛特的组暂停持续时间较短（P < 0.01）。两组吞咽困难极限均为15毫升。前冲/回弹爆发持续时间、喉抬高、关闭和悬吊时间相似（P = 0.954）。我们得出结论，全甲状腺切除术中在喉与带状肌之间使用施沛特对吞咽没有任何不良影响。抗粘连屏障可在甲状腺手术中安全使用。
