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Human cadaveric model for studying the preservation of mental nerve during transoral endoscopic thyroidectomy

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Abstract

Purpose

Mental nerve (MN) injury can be caused by transoral endoscopic thyroidectomy vestibular approach (TOETVA). The purpose of this experimental study was to determine the location and distribution pattern of MN structures in relation to oral vestibular incisions.

Methods

Ten cadaver specimens were included, yielding a total of 20 MNs. The difference between standard 10-mm TOETVA median incision and modified incision (i.e. lower and perpendicular) was compared.

Results

All 20 MNs were successfully dissected and presented as bifid (100%), lateral toward medial direction. The branches of MNs were equally distributed into both right and left sides. Standard lateral 5-mm vestibular incisions did not determine any division of MN branches. Two left MNs (25%) and one right MN (12.5%) were injured by standard median vestibular incision. Using a more inferiorly positioned and a vertical median incision, the integrity of MN branches was preserved.

Conclusions

Standard lateral 5-mm vestibular incisions are safe for determining MN integrity. The 10-mm median vestibular incision divided the medial ramifications of MN at a rate of 12–25%. These may result in MN ipsilateral or bilateral paralysis. Hence, it is recommended to locate the median incision more inferiorly or vertically.

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Funding

This study was funded by China Postdoctoral Science Foundation (No. 2017M611313), Department of Science and Technology of Jilin Province (No. 20170520018JH and 20190201225JC) and Department of Finance of Jilin Province (No. SCZSY201714 and SCZSY201504), China.

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Authors and Affiliations

  1. Division of thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, 126 Xiantai Blvd, Changchun, Jilin, People’s Republic of China

    Daqi Zhang, Yantao Fu & Hui Sun

  2. Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood ‘‘G. Barresi’’, University Hospital G. Martino, University of Messina, Via C. Valeria 1, 98125, Messina, Italy

    Gianlorenzo Dionigi, Alessandro Pontin, Ettore Caruso & Pino Antonella

Authors
  1. Daqi Zhang
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  2. Yantao Fu
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  3. Gianlorenzo Dionigi
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  4. Alessandro Pontin
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  5. Ettore Caruso
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  6. Pino Antonella
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  7. Hui Sun
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Contributions

Zhang Dq: project development, data collection, and manuscript writing. Fu Yt: data collection and manuscript writing. Dionigi G: project development and manuscript writing. Pontin A: data management and manuscript writing. Caruso E: data collection and manuscript writing. Antonella P: data collection and manuscript writing. Sun H: project development, data collection, and manuscript writing

Corresponding author

Correspondence to Hui Sun.

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Conflict of interest

The authors Daqi Zhang, Yantao Fu, Gianlorenzo Dionigi, Alessandro Pontin, Ettore Caruso, Pino Antonella and Hui Sun have no conflict of interest to disclose, and no other funding or financial relationship with the surgical industry.

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This article does not contain any studies with human participants performed by any of the authors.

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Informed consent not applicable in the present study.

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Zhang, D., Fu, Y., Dionigi, G. et al. Human cadaveric model for studying the preservation of mental nerve during transoral endoscopic thyroidectomy. Surg Radiol Anat 42, 55–62 (2020). https://doi.org/10.1007/s00276-019-02306-8

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  • DOI: https://doi.org/10.1007/s00276-019-02306-8

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