{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T11:10:40Z","timestamp":1784805040477,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine (1) the relationship between anthropometric measurements and recurrent laryngeal nerve (RLN) diameter; (2) whether thin RLNs have different baseline electromyographic (EMG) characteristics; (3) if thin or branched morphology is associated with increased risk of EMG adverse events, loss of signal (LOS) or vocal cord paresis\/paralysis (VCP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective study, anthropometric data were collected, including weight, height, body mass index (BMI), neck circumference, shoulder diameter, and circumference of the right middle finger (RMF) or right ring finger (RRF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We enrolled 216 patients who underwent surgery from 2016 to 2020 with 307 RLNs at risk. Thin nerves were defined as those \u2264\u20091.5\u2009mm in diameter. The mean RLN diameter was 2\u2009mm; the RLN was thinner in females and in patients with BMI\u2009&lt;\u200920\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , body weight\u2009&lt;\u2009120\u2009kg, height\u2009&lt;\u2009175\u2009cm, neck circumference\u2009&lt;\u200940\u2009cm, shoulder diameter\u2009&lt;\u200950\u2009cm, and RMF or RRF\u2009&lt;\u20097.6\u2009cm (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). No statistically significant differences were detected in baseline EMG characteristics between thin and thick RLNs bilaterally (except for right RLN R2 latency). We had zero cases of LOS or VCP. In all branched nerves, motor fibers resided in the anterior branch.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multiple anthropometric factors were associated with RLN diameter. Most of the studied EMG signal characteristics did not statistically differ by RLN diameter. With zero events of LOS or VCP, our study is not powered to determine if thin diameter or branching are independent risk factors for RLN injury in a high\u2010volume endocrine surgery practice utilizing IONM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.28236","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T02:29:08Z","timestamp":1751596148000},"page":"3123-3130","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Anthropometric Measures, Recurrent Laryngeal Nerves Diameter, Electromyographic Responses and Vocal Cord Paralysis Risk"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1029-3954","authenticated-orcid":false,"given":"Bo","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Thyroid Surgery Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5611-5833","authenticated-orcid":false,"given":"Amr H.","family":"Abdelhamid Ahmed","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7329-8560","authenticated-orcid":false,"given":"Anthony Y.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Okenwa C.","family":"Okose","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dioan","family":"McIlroy","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka J.","family":"Iwata","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Otolaryngology Head and Neck Surgery Kaiser Permanente Santa Clara Medical Center  Santa Clara California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian J.","family":"Behr","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2765-5413","authenticated-orcid":false,"given":"Dipti","family":"Kamani","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Dralle","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery University of Duisburg Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger L.","family":"Crumley","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Whitney","family":"Liddy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1358-774X","authenticated-orcid":false,"given":"Amanda Silver","family":"Karcioglu","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Otolaryngology\u2010Head and Neck Surgery, Department of Surgery NorthShore University HealthSystem  Evanston Illinois USA"},{"name":"The University of Chicago, Pritzker School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Kandil","sequence":"additional","affiliation":[{"name":"Department of Surgery Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery Martin Luther University of Halle\u2010Wittenberg  Halle (Saale) Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1052-5348","authenticated-orcid":false,"given":"Che\u2010Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery, Faculty of Medicine Kaohsiung Medical University Hospital, College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery Martin Luther University of Halle\u2010Wittenberg  Halle (Saale) Germany"},{"name":"Department of Endocrine Surgery Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Almquist","sequence":"additional","affiliation":[{"name":"Endocrine\u2010Sarcoma Unit, Department of Surgery Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Brauckhoff","sequence":"additional","affiliation":[{"name":"Department of Breast and Endocrine Surgery Haukeland University Hospital  Bergen Norway"},{"name":"Department of Clinical Science University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2180-7893","authenticated-orcid":false,"given":"Erivelto M.","family":"Volpi","sequence":"additional","affiliation":[{"name":"Head and Neck Department Oncology Center, Oswaldo Cruz German Hospital  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Rangel","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology\u2010Head and Neck Surgery State University of Rio de Janeiro  Rio de Janiero Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Tolley","sequence":"additional","affiliation":[{"name":"Hammersmith Hospital, Imperial College NHS Healthcare Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"McMullen","sequence":"additional","affiliation":[{"name":"Department of Head and Neck\u2010Endocrine Oncology Program Moffit Cancer Center  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Kroeker","sequence":"additional","affiliation":[{"name":"The Texas Thyroid and Parathyroid Center  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6062-1851","authenticated-orcid":false,"given":"Marcin","family":"Barczynski","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery Jagiellonian University Medical College  Krakow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2462-6775","authenticated-orcid":false,"given":"Yoshiyuki","family":"Saito","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Surgery Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Takami","sequence":"additional","affiliation":[{"name":"Department of Surgery Ito Hospital  Tokyo 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Martino University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Kyriazidis","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5436-3649","authenticated-orcid":false,"given":"Marika D.","family":"Russell","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2025-4246","authenticated-orcid":false,"given":"Wen\u2010Xin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Thyroid Surgery Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory W.","family":"Randolph","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Surgery Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0218"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2021.0155"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26440"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2008.01875.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-010-0928-0"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2007.07.017"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28210"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30115"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21119"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0316-8"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-26219-5"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2016.12.039"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/ve.2015.0038"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.07.018"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-020-05549-4"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-014-2820-8"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24468"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27359"},{"issue":"6","key":"e_1_2_10_20_1","first-page":"S1","article-title":"Clinical Practice Guideline: Improving Voice Outcomes After Thyroid Surgery","volume":"148","author":"Chandrasekhar S. 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