Why the study?
Does laryngoscopic examination prevent bilateral paralysis of the vocal cords in patients undergoing total ablation of the thyroid for angina pectoris or congestive heart failure?
Does laryngoscopic examination prevent bilateral paralysis of the vocal cords in patients undergoing total ablation of the thyroid for angina pectoris or congestive heart failure?
Highlights the anatomical risks to the recurrent laryngeal nerve during total thyroid ablation for heart failure and angina, emphasizing the need for laryngoscopic examination to prevent vocal cord paralysis.
May warrant preoperative laryngoscopy to mitigate nerve injury in thyroid surgery; leaves open impact on paralysis rates in contemporary practice.
Blumgart and his co-workers,1at the Beth Israel Hospital in Boston, recently reported the therapeutic results of total ablation of the thyroid gland in patients with angina pectoris or congestive heart failure. Berlin,2who developed and first described the operation, realized at the outset the danger of injury to the recurrent laryngeal nerves because of the intimate anatomic relation between the thyroid and these nerves. This relationship is particularly close just below the arch of the cricoid in the area of fixation of the thyroid to the trachea, which Berlin described as the "adherent zone." In this area the nerve often traverses strands of fascial tissues connecting the thyroid to the trachea and has a varying relationship to the inferior thyroid artery. Berlin and Lahey3showed that the recurrent laryngeal nerve is more often anterior to the inferior thyroid artery on the right than on the left
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Lester Freedman (1934) studied this question.
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