Identifikasi Nervus Laringeus Rekuren pada Tiroidektomi dan Ismolobektomi dengan Menentukan Vasa Nervorum pada Nervus Laringeus Rekuren Saat Pembedahan di RSUP Prof. Dr. R. D. Kandou Manado Periode 2017-2018
DOI:
https://doi.org/10.35790/ecl.v11i3.44763Abstract
Abstract: There are two sets of nerves near the thyroid gland for voice control namely recurrent laryngeal nerve and external branch of the superior laryngeal nerve. There peripheral nerves rely on blood supply to maintain their structural and functional requirements, therefore, their vasa nervorum have to be identified in thyroidectomy and isthmolobectomy. This study aimed to obtain data on vasa nervorum whether it was visible or not in the recurrent laryngeal nerve during thyroidectomy and isthmolobectomy. This was a retrospective study using medical record data of observed vasa nervorum in all patients undergoing elective surgery for thyroidectomy and isthmolobectomy at Prof. Dr. R. D. Kandou Hospital in 2017-2018. The results obtained 48 cases who underwent elective surgery for thyroidectomy and isthmolobectomy. There were 33 cases with excellent visualization of the vasa nervorum against the recurrent laryngeal nerve (+++), 15 cases were visible but not very clear (++), and three cases were vague and difficult to observe (+). In conclusion, in most thyroidectomy and isthmolobectomy surgeries at Prof. Dr. R. D. Kandou Hospital visualization of vasa nervorum on recurrent laryngeal nerve is excellent to prevent nerve injury. Visual identification and dissection of this nerve is a standard technique to prevent the nerve injury during thyroidectomy or isthmolobectomy and other open neck surgeries.
Keywords: recurrent laryngeal nerve; superior laryngeal nerve; thyroidectomy; isthmolobectomy
Abstrak: Terdapat dua kelompok saraf di dekat kelenjar tiroid yang membantu mengendalikan suara, yaitu nervus laringeus rekuren dan cabang eksternal nervus laringeus superior. Saraf perifer ini bergantung pada pasokan darah untuk mempertahankan kebutuhan struktural dan fungsional; oleh karena itu, vasa nervorum perlu diidentifikasi pada operasi tiroidektomi dan ismolobektomi. Penelitian ini bertujuan untuk mendapatkan data tentang vasa nervorum yang teramati pada nervus laringeus rekuren selama operasi tiroidektomi dan ismolobektomi. Jenis penelitian ialah retrospektif menggunakan rekam medis mengenai kasus vasa nervorum yang diamati pada semua pasien yang menjalani operasi elektif untuk tiroidektomi dan isthmolobectomi di RSUP Prof. Dr. R. D. Kandou Manado pada 2017-2018. Hasil penelitian mendapatkan 48 kasus yang menjalani operasi elektif untuk tiroidektomi dan ismolobectomi. Terdapat 33 kasus dengan visualisasi vasa nervorum terhadap nervus laringeus rekuren sangat baik (+++), 15 kasus terlihat tetapi tidak terlalu jelas (++), dan tiga kasus samar-samar dan sulit diobservasi (+). Simpulan penelitian ini ialah pada sebagian besar operasi tiroidektomi dan ismolobektomi di RSUP Prof. Dr. R. D. Kandou Manado telah dilakukan visualisasi vasa nervorum terhadap nervus laringeus rekuren yang jelas untuk menghindari cedera pada nervus laringeus rekuren. Identifikasi visual dan diseksi nervus laringeus rekuren sekarang merupakan teknik standar untuk menghindari cedera nervus tersebut selama tiroidektomi atau ismolobektomi dan operasi leher terbuka lainnya.
Kata kunci: nervus laringeus rekuren; nervus laringeus superior; tiroidektomi; ismolobektomi
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