RESUMEN
Impairment of laryngotracheal movement is a possible complication after total thyroidectomy. Here, we aimed to investigate the frequency and extent of impairment of laryngotracheal movement after total thyroidectomy and the effect of anti-adhesive barrier hyaluronic acid-carboxymethylcellulose membrane positioning between strap muscles and laryngotracheal complex on deglutition. The study design is prospective clinical study. Istanbul Training and Research Hospital, Laboratory of Electrophysiology, Istanbul Training and Research Hospital. The patients who underwent total thyroidectomy were selected and dichotomized according to use of seprafilm. Each group consisted of 8 female patients. All patients were assessed clinically and electrophysiologically in the pre/postop period. Electrophysiological investigations included cricopharyngeal muscle (CPM) electromyography (EMG), submental EMG, single bolus analysis [foreburst, reburst, swallowing (pause) patterns], laryngotracheal movement analysis and results were compared between two groups. CPM EMG was normal in both groups. Duration of submental muscle activity during dry and 15 cc water swallowing was similar between two groups (P = 0.751). Pause duration was shorter in group with seprafilm (P < 0.01). Dysphagia limit was 15 cc in both groups. The fore/rebound bursts duration, the time of laryngeal elevation, closure and suspension were similar (P = 0.954). We concluded that use of seprafilm between larynx and strap muscles during total thyroidectomy does not have any adverse effects on swallowing. Anti-adhesive barrier can be used safely during thyroid surgery.
RESUMEN
Vascular malformations can be categorized into low-flow lesions and high-flow lesions according to blood flow volume. Arterial lesions such as arteriovenous malformations (AVMs) are generally high-flow lesions. Arteriovenous malformations are high-flow vascular anomalies consisting of a nidus or a network of abnormal vascular channels between feeding arteries and draining veins. Arteriovenous malformations become destructive progressively by compression or erosion of surrounding tissue by itself. Angiography is the most important diagnostic technique for determination of location and flow characteristics of vascular lesions. Embolization is used preoperatively to decrease the size of AVM and reduce the extent of surgical excision. The modern treatment of AVM requires multidisciplinary study between the surgeon and vascular radiologist. We reported an early diagnosed AVM at the lower lip, and it was resected totally intraorally without any complication and morbidity.
