Wang Jia Joanna, Lu I-Cheng, Chang Pi-Ying, Wu Che-Wei, Wang Ling-Feng, Huang Tzu-Yen, Chiang Feng-Yu
Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Gland Surg. 2020 Jun;9(3):802-805. doi: 10.21037/gs.2020.03.36.
We report a patient with right substernal goiter and preoperative vocal cord palsy (VCP). During dissection, an anatomic variation of the recurrent laryngeal nerve (RLN) and a prolonged EMG were detected by intraoperative neuromonitoring (IONM). Symmetrical vocal cord movement was recorded one month after surgery. The potential for recovery of vocal cord function is high after surgical treatment of a thyroid tumor with preoperative VCP. An IONM enables early localization of the RLN position. To the best of our knowledge, this case of prolonged EMG in an abnormal acquired-ventral RLN trajectory is the first reported in the literature.
我们报告一例患有右胸骨后甲状腺肿且术前存在声带麻痹（VCP）的患者。在手术解剖过程中，通过术中神经监测（IONM）检测到喉返神经（RLN）的解剖变异和延长的肌电图（EMG）。术后一个月记录到声带对称运动。术前VCP的甲状腺肿瘤手术治疗后，声带功能恢复的可能性很高。IONM能够早期定位RLN位置。据我们所知，这种异常获得性腹侧RLN走行中延长EMG的病例是文献中首次报道。
