{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:43:12Z","timestamp":1757702592526},"reference-count":16,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,3,19]],"date-time":"2015-03-19T00:00:00Z","timestamp":1426723200000},"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":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2015,12]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>In thyroidectomy, little has been reported on the differential recurrent laryngeal nerve (RLN<\/jats:styled-content>) palsy rates between the left and right sides. Even less is known about the potential differences causing these differential rates. This study reports the left versus right RLN<\/jats:styled-content> palsy rates of total thyroidectomy cases in a single institution, relating them to the comparative stiffness of the left and right porcine RLNs<\/jats:styled-content>. Computed stress modelling was also used to estimate the differential levels of tension within each RLN<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>For the comparison of the left and right RLN<\/jats:styled-content> palsy rates, 1926 cases of total thyroidectomy (between 2007 and 2013) from the M<\/jats:styled-content>onash U<\/jats:styled-content>niversity E<\/jats:styled-content>ndocrine S<\/jats:styled-content>urgery U<\/jats:styled-content>nit were included. Stiffness of porcine RLNs<\/jats:styled-content> was experimentally determined by measuring nerve extension against incremental increase in load. Additionally, the tension of intraoperatively stretched RLNs<\/jats:styled-content> was estimated by computer modelling.<\/jats:p><\/jats:sec>Results<\/jats:title>The left RLN<\/jats:styled-content> had a palsy rate of 0.9% (18\/1926), which was significantly lower (P<\/jats:italic><\/jats:styled-content> = 0.025) than the right RLN<\/jats:styled-content> palsy rate of 1.8% (34\/1926). The left porcine RLN<\/jats:styled-content> was 22% stiffer than the right RLN<\/jats:styled-content> (P<\/jats:italic><\/jats:styled-content> = 0.004). The stress modelling estimated that at the apex of the artificial RLN<\/jats:styled-content> genu during anteromedial rotation of the thyroid lobe, the right RLN<\/jats:styled-content> experiences twice the tension experienced by the left RLN<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The stiffer left RLN<\/jats:styled-content> and the higher tension generated in the right RLN<\/jats:styled-content> during thyroidectomy may jointly contribute to the higher right RLN<\/jats:styled-content> palsy rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13054","type":"journal-article","created":{"date-parts":[[2015,3,19]],"date-time":"2015-03-19T09:43:30Z","timestamp":1426758210000},"page":"962-965","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Stressing the recurrent laryngeal nerve during thyroidectomy"],"prefix":"10.1111","volume":"85","author":[{"given":"Jonathan W.","family":"Serpell","sequence":"first","affiliation":[{"name":"Monash University Endocrine Surgery Unit Alfred Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Monash University Endocrine Surgery Unit Alfred Hospital Melbourne Victoria Australia"},{"name":"Department of Surgery Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wing K.","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Animal and Veterinary Sciences Charles Sturt University Wagga Wagga New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,3,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2006.03897.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2012.06247.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.134.12.1389"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2008.01875.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2004.16.5.2"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2007.07.017"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2004.09.008"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-010-0013-7"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2007.09.006"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-003-6903-1"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000129357.58265.3c"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200009000-00011"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197301000-00002"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000370203.26164.24"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949610500201"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-010-0928-0"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fans.13054","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.13054","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T00:19:23Z","timestamp":1695514763000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.13054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3,19]]},"references-count":16,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1111\/ans.13054"],"URL":"https:\/\/doi.org\/10.1111\/ans.13054","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3,19]]},"assertion":[{"value":"2015-01-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-03-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}