Patient who has thyroid tumor or thyrotoxicosis whom will be treated by thyroid lobectomy,
Conditions
Interventions
1. Patient is under GA,
supine position with extended neck
2. Low collar incision is made through subcutaneous & platysma,
superior & inferior subplatysma flaps are done.
3. Strap muscles are separated vertically in the midline & retracted laterally
4. Superior thyroid vessels are identified and ligated
5. Superior parath
the nerve is gently separate from surrounding tissue until entering to the larynx
10. The thyroid lobe is removed from its tracheal attachment by dividing the ligament of berry
, 1. Patient is under
superior & inferior subplatysma flaps are done
3. Strap muscles are separated vertically in the midline & retracted laterally
4. Superior thyroid vessels are identified and ligated
5. Identification t
Experimental Procedure/Surgery,Experimental Procedure/Surgery
Thyroidectomy with conventional technique ,Thyroidectomy with using IONM technique
Sponsors
Faculty of Medicine Siriraj Hospital
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Inclusion criteria 1. Age more than 18 years old 2. Patient who will be treated by thyroid lobectomy, subtotal thyroidectomy, total thyroidectomy 3. Patient can come to follow up after surgery Inclusion criteria of the surgeon 1. The surgeon is a second year Otorhinolaryngology resident, Faculty of Medicine, Siriraj hospital, Thailand. 2. The surgeon has done enough thyroid surgery under staff supervision until passing the evaluation for standard thyroidectomy procedure by the staffs before entering the study.
Exclusion criteria
Exclusion criteria: Exclusion criteria 1. Preoperative vocal cord paralysis or paresis 2. History of neck surgery, radiation at head and neck region 3. Substernal goiter 4. Advance stage of well differentiated thyroid cancer (T4, tumor invasion or N > 1 clinical lymph node metastasis), poorly differentiated or anasplastic thyroid cancer 5. BMI >35 kg/m2 6. The patient that have contraindication of using succinylcholine, midazolam, fentanyl, inhalation agents 7. An unplanned neck dissection Exclusion criteria of the surgeon -
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| nerve identification time (minutes) 12 months Compare identification time between two groups | — |
Secondary
| Measure | Time frame |
|---|---|
| total operative time (minute),Prevalence of RLN injury 12 months compare operative time and prevalence of RLN injury between two groups | — |
Countries
Thailand
Contacts
Public ContactCheerasook Chongkolwatana
Faculty of Medicine Siriraj Hospital, Mahidol University
Outcome results
None listed