Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve

Technological advances in thyroid surgery have rapidly increased in recent decades. Specifically, recently developed energy-based devices (EBDs) enable simultaneous dissection and sealing tissue. EBDs have many advantages in thyroid surgery, such as reduced blood loss, lower rate of post-operative h...

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Autores principales:	Jia Joanna Wang, Tzu-Yen Huang, Che-Wei Wu, Yi-Chu Lin, Hsin-Yi Tseng, Cheng-Hsin Liu, I-Cheng Lu, Pi-Ying Chang, Hui-Chun Chen, Hsiu-Ya Chen, Gianlorenzo Dionigi, Feng-Yu Chiang, Ling-Feng Wang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	energy-based devices safety parameter recurrent laryngeal nerve thyroid surgery voice Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/1e3450f28ac140be9bbd576f28830a72
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spelling	oai:doaj.org-article:1e3450f28ac140be9bbd576f28830a722021-12-01T08:30:31ZImproving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve1664-239210.3389/fendo.2021.793431https://doaj.org/article/1e3450f28ac140be9bbd576f28830a722021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.793431/fullhttps://doaj.org/toc/1664-2392Technological advances in thyroid surgery have rapidly increased in recent decades. Specifically, recently developed energy-based devices (EBDs) enable simultaneous dissection and sealing tissue. EBDs have many advantages in thyroid surgery, such as reduced blood loss, lower rate of post-operative hypocalcemia, and shorter operation time. However, the rate of recurrent laryngeal nerve (RLN) injury during EBD use has shown statistically inconsistent. EBDs generate high temperature that can cause iatrogenic thermal injury to the RLN by direct or indirect thermal spread. This article reviews relevant medical literatures of conventional electrocauteries and different mechanisms of current EBDs, and compares two safety parameters: safe distance and cooling time. In general, conventional electrocautery generates higher temperature and wider thermal spread range, but when applying EBDs near the RLN adequate activation distance and cooling time are still required to avoid inadvertent thermal injury. To improve voice outcomes in the quality-of-life era, surgeons should observe safety parameters and follow the standard procedures when using EBDs near the RLN in thyroid surgeryJia Joanna WangJia Joanna WangTzu-Yen HuangTzu-Yen HuangChe-Wei WuChe-Wei WuYi-Chu LinHsin-Yi TsengCheng-Hsin LiuCheng-Hsin LiuI-Cheng LuPi-Ying ChangHui-Chun ChenHsiu-Ya ChenGianlorenzo DionigiGianlorenzo DionigiFeng-Yu ChiangFeng-Yu ChiangLing-Feng WangFrontiers Media S.A.articleenergy-based devicessafety parameterrecurrent laryngeal nervethyroid surgeryvoiceDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	energy-based devices safety parameter recurrent laryngeal nerve thyroid surgery voice Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	energy-based devices safety parameter recurrent laryngeal nerve thyroid surgery voice Diseases of the endocrine glands. Clinical endocrinology RC648-665 Jia Joanna Wang Jia Joanna Wang Tzu-Yen Huang Tzu-Yen Huang Che-Wei Wu Che-Wei Wu Yi-Chu Lin Hsin-Yi Tseng Cheng-Hsin Liu Cheng-Hsin Liu I-Cheng Lu Pi-Ying Chang Hui-Chun Chen Hsiu-Ya Chen Gianlorenzo Dionigi Gianlorenzo Dionigi Feng-Yu Chiang Feng-Yu Chiang Ling-Feng Wang Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve
description	Technological advances in thyroid surgery have rapidly increased in recent decades. Specifically, recently developed energy-based devices (EBDs) enable simultaneous dissection and sealing tissue. EBDs have many advantages in thyroid surgery, such as reduced blood loss, lower rate of post-operative hypocalcemia, and shorter operation time. However, the rate of recurrent laryngeal nerve (RLN) injury during EBD use has shown statistically inconsistent. EBDs generate high temperature that can cause iatrogenic thermal injury to the RLN by direct or indirect thermal spread. This article reviews relevant medical literatures of conventional electrocauteries and different mechanisms of current EBDs, and compares two safety parameters: safe distance and cooling time. In general, conventional electrocautery generates higher temperature and wider thermal spread range, but when applying EBDs near the RLN adequate activation distance and cooling time are still required to avoid inadvertent thermal injury. To improve voice outcomes in the quality-of-life era, surgeons should observe safety parameters and follow the standard procedures when using EBDs near the RLN in thyroid surgery
format	article
author	Jia Joanna Wang Jia Joanna Wang Tzu-Yen Huang Tzu-Yen Huang Che-Wei Wu Che-Wei Wu Yi-Chu Lin Hsin-Yi Tseng Cheng-Hsin Liu Cheng-Hsin Liu I-Cheng Lu Pi-Ying Chang Hui-Chun Chen Hsiu-Ya Chen Gianlorenzo Dionigi Gianlorenzo Dionigi Feng-Yu Chiang Feng-Yu Chiang Ling-Feng Wang
author_facet	Jia Joanna Wang Jia Joanna Wang Tzu-Yen Huang Tzu-Yen Huang Che-Wei Wu Che-Wei Wu Yi-Chu Lin Hsin-Yi Tseng Cheng-Hsin Liu Cheng-Hsin Liu I-Cheng Lu Pi-Ying Chang Hui-Chun Chen Hsiu-Ya Chen Gianlorenzo Dionigi Gianlorenzo Dionigi Feng-Yu Chiang Feng-Yu Chiang Ling-Feng Wang
author_sort	Jia Joanna Wang
title	Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve
title_short	Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve
title_full	Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve
title_fullStr	Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve
title_full_unstemmed	Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve
title_sort	improving voice outcomes after thyroid surgery – review of safety parameters for using energy-based devices near the recurrent laryngeal nerve
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/1e3450f28ac140be9bbd576f28830a72
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Improving Voice Outcomes After Thyroid Surgery – Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve

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