METHOD FOR DETERMINING TOPOGRAPHY OF EXTERNAL BRANCH OF SUPERIOR LARYNGEAL NERVE IN THYROID SURGERIES Russian patent published in 2024 - IPC A61B17/00 A61B5/05 A61N1/04 A61B5/24 

FIELD: medicine; surgery.

SUBSTANCE: thyroid lobe is mobilized before crossing the vessels of the upper pole. Stimulation of upper pole structures of thyroid gland is carried out, and topography of external branch of upper laryngeal nerve is preliminary determined. Further, the cricothyroid muscle is stimulated to transect the vessels of the upper pole with the help of a monopolar stimulator probe. Path and position of the nerve in the case of its variant anatomy is determined by an external branch of the superior laryngeal nerve and contraction of the cricothyroid muscle in response to its stimulation. If observing the topography of the external branch of the superior laryngeal nerve, taking into account the anatomical features of the innervation of the larynx, a bipolar stimulator probe is used to accurately determine the course of the topography of the nerve. When the mono- or bipolar probe-stimulator reaches the external branch of the superior laryngeal nerve on the monitor of the electromyographic data recording unit, a graphic signal is displayed in the form of a curve with amplitude and latency parameters, sound signal is sent from said unit. Further, the location and course of the external branch of the superior laryngeal nerve relative to the vessels of the superior pole ensuring the possibility of excluding its intersection or falling into the ligature at the surgical stage of crossing the vessels of the upper pole of the thyroid gland. If the nerve was not detected during the operation or is located proximal to the place of the proposed ligature, contraction of the cricothyroid muscle before and after crossing the vessels of the upper pole confirms the functionality of the external branch of the superior laryngeal nerve, which provides motor innervation of the above muscle.

EFFECT: method enables to determine the topography of the external branch of the superior laryngeal nerve during operations on the thyroid gland, detect injuries of reciprocal laryngeal nerve and external branch of superior laryngeal nerve in real time, reduce probability of complications with disturbed phonation in patients in postoperative period.

1 cl, 1 dwg, 1 ex