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17212

The Identification of Recurrent Laryngeal Nerve by Injection of Blue Dye into the Inferior Thyroid Artery

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Last updated: 24 Dec 2024

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Abstract

Background: Thyroidectomy creates a potential risk for injury of the recurrent laryngeal nerve (RLN). The identification and dissection of the RLN is the gold standard for preserving its function. Aim of the work: was to evaluate the value of injection of methylene blue dye into the inferior thyroid artery for help of the identification and dissection of RLN. Patients and Methods: This study included 60 selected patients who underwent thyroid surgery divided into 2 groups. In group A (30 patients) the branches of the inferior thyroid artery (ITA) near to the capsule of the thyroid lobe were isolated, and then 0.5 ml methylene blue dye was injected into the artery. In group B (30 patients) the RLN identified without help of dye to be compared with group A cases. Results: During injection of dye bleeding from the ITA occurred in 7 patients. The identification of the RLN within the painted tissue was succeeded 28 patients and failed in 2 patients due to extravasation of the dye. Regarding the amount of blood loss, there was a significant difference between the groups as the average amount of blood loss in group A was 85±22 ml (range 70-120) and in group B was 105±37 ml (range 90-160) P = 0.01.  Also, by comparing the time taken for RLN identification in one side, there was a significant difference between the groups, as the median time taken for single RLN identification in each case in group A was 9±2 min (range 7-12 min) and in group B was 14±3 min (range 10-20 min) P = 0.008. Conclusion: the injection of methylene blue dye into the inferior thyroid artery or its branches is a feasible, effective, reliable way that can be used as a method for the identification of the RLN during thyroidectomy.

DOI

10.21608/ejhm.2018.17212

Keywords

methylene blue, Recurrent laryngeal nerve, thyroid surgery

Authors

First Name

Amr

Last Name

Salah

MiddleName

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Affiliation

Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

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Orcid

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First Name

Mohamed

Last Name

Mamdoh

MiddleName

-

Affiliation

Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

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Orcid

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First Name

Nader

Last Name

Abd-Elhamid

MiddleName

-

Affiliation

Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Email

naderzaid1969@yahoo.com

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-

Orcid

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Volume

73

Article Issue

6

Related Issue

3486

Issue Date

2018-10-01

Receive Date

2018-10-21

Publish Date

2018-10-01

Page Start

6,967

Page End

6,972

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_17212.html

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https://ejhm.journals.ekb.eg/service?article_code=17212

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28

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

The Identification of Recurrent Laryngeal Nerve by Injection of Blue Dye into the Inferior Thyroid Artery

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Article

Created At

22 Jan 2023