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  • Title: Assessment of recurrent laryngeal nerve during thyroid surgery with laryngeal mask airway.
    Author: Pott L, Swick JT, Stack BC.
    Journal: Arch Otolaryngol Head Neck Surg; 2007 Mar; 133(3):266-9. PubMed ID: 17372084.
    Abstract:
    OBJECTIVE: To study the feasibility of using laryngeal mask anesthesia (LMA) with bronchoscopic evaluation of recurrent laryngeal nerve (RLN) integrity when stimulated. DESIGN: Single-institution prospective case series. SETTING: A single, mid-Atlantic region academic medical center. PATIENTS: Twenty-seven adult volunteers. INTERVENTIONS: Laryngeal mask anesthesia for thyroid surgery, monitored by flexible laryngoscopy and nerve integrity testing. MAIN OUTCOME MEASURES: Success rates for LMA use in thyroid surgery, bronchoscopic visualization of laryngeal glottis, and documentation of RLN integrity following surgery. RESULTS: We report our experience on 27 consecutive cases in which LMA with RLN stimulation was used for thyroid surgery. Twenty-five of 27 patients underwent successful LMA and visual documentation of RLN integrity by bronchoscopic inspection of nerve stimulation. CONCLUSIONS: Direct visualization of vocal cords using a fiberoptic bronchoscope via an LMA provides a safe and feasible method of laryngeal assessment following thyroid dissection. Continuous real-time video monitoring may be the next step in development of this technique as a patient safety measure for thyroid and parathyroid surgery.
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