2,003 research outputs found
IONM of the Recurrent Laryngeal Nerve
No full textThyroid surgery can pose risk to both the right and the left recurrent laryngeal nerves (RLN) in a single surgical procedure. Unilateral vocal cord palsy (VCP) can lead to morbidity related to changes in voice, especially in professional voice users, as well as potential dysphagia and aspiration, while bilateral VCP may require tracheostomy. Visualization of the RLN during surgery has been considered the gold standard for preventing injury to the RLN; however, an intraoperatively visualized and structurally intact nerve does not necessarily represent a postoperatively functioning nerve. Neural monitoring has increasingly gained the attention of surgeons performing thyroid and parathyroid surgeries around the world. Current studies suggest that a majority of general and head and neck surgeons use neural monitoring in at least some of their thyroid surgical cases. This chapter presents a historical overview and usage patterns of intraoperative neural monitoring (IONM) of the RLN and discusses its impact on surgical practice, including intraoperative applications of IONM, medicolegal aspects and standards of IONM, normative data, as well as current advances in IONM such as continuous IONM
The International RLN Anatomic Classification System
No full textWith this chapter we offer an anatomy-based classification system of recurrent laryngeal nerve (RLN); a classification that embraces normal anatomy as well as embryological and acquired sources of variation in the trajectory of the right and left RLN in human neck. We endeavor to put forth a classification system that encompasses all of the above sources of variations and is simple and surgically relevant so that it is maximally valuable to the surgeon during thyroidectomy.
This classification system relates to the path/trajectory of the main trunk of the RLN. We appreciate that specific interactions between the nerve and the thyroid gland occur at the tubercle of Zuckerkandl (described in Chap. 9), ligament of Berry (described in Chap. 10) and with the inferior thyroid artery (described in Chap. 7). The surgical approach to the nerve can be conceptualized in a number of different ways and this is detailed in Chap. 13. In this chapter both the basic classification of RLN surgical anatomic path in the neck base as it relates to the thyroid surgery as well as vagal carotid sheath anatomy are described
Intraoperative Neural Injury Management: Neuropraxic Non-transection Injury
No full textDuring thyroid surgery, the macroscopically intact recurrent laryngeal nerve (RLN) may cease to function, even though it is not transected. Traction, cautery, pressure, crush, or being tied in surrounding tissue are some causes of impaired function during surgery. Invisible RLN injuries (such as thermal, traction, compression, contusion, or pressure) are not detected by the surgeon’s eye; only a functional assessment of the RLN with intraoperative nerve monitoring (IONM) can detect such insults. With the application of IONM, we appreciate that traction is the major cause of RLN injury during thyroid surgery
SIDE 1: Dick Gregory
No full textThis audio recording features an episode of Martin Luther King, Jr./SCLC Speaks. In this episode, as stated by the narrator, the "wit and wisdom" of comedian and civil rights leader Dick Gregory are featured. Gregory speaks about racism in America and the struggles of the civil rights movement as well as commentary on the healthcare system. Gregory includes moments of levity in his remarks, such as where he speaks about Michael Jackson's adoption of a chimpanzee as a pet.The Atlanta University Center Robert W. Woodruff Library acknowledges the generous support of the Joseph & Evelyn Lowery Institute for Justice and Human Rights, the Joseph Echols Lowery Irrevocable Trust, and other donors in supporting the processing and digitization of Morehouse College's Joseph Echols and Evelyn Gibson Lowery Collection
Dick Gregory Speaks at a Youth Drug and Alcohol Abuse Campaign Event, April 15, 1986
No full textDick Gregory speaks at a Southern Christian Leadership Conference campaign event advocating against youth drug and alcohol abuse. Written on verso: Dick Gregory addresses the enthusiastic crowd against the use of drugs.The Atlanta University Center Robert W. Woodruff Library acknowledges the generous support of the Joseph & Evelyn Lowery Institute for Justice and Human Rights, the Joseph Echols Lowery Irrevocable Trust, and other donors in supporting the processing and digitization of Morehouse College's Joseph Echols and Evelyn Gibson Lowery Collection
Dick Gregory Speaking at a SCLC Board Meeting, April 1990
No full textDick Gregory is shown speaking at a Southern Christian Leadership Conference Spring Board meeting held at Grace Temple Baptist Church in Detroit, Michigan.The Atlanta University Center Robert W. Woodruff Library acknowledges the generous support of the Joseph & Evelyn Lowery Institute for Justice and Human Rights, the Joseph Echols Lowery Irrevocable Trust, and other donors in supporting the processing and digitization of Morehouse College's Joseph Echols and Evelyn Gibson Lowery Collection
Dick Gregory Receiving a Drum Major for Justice Award, January 15, 1980
No full textJoseph E. Lowery (at left), Charles Kenzie Steele (first on the right), and Wyatt Tee Walker present Dick Gregory (second from the left) with a Drum Major for Justice Award. Written on verso: Atlanta, Ga. Jan. 15, 1980, Rev. C.K. Steele presenter of the Drum Major Award to Dick Gregory, at the first annual Martin Luther Award Memorial Dinner at the Atlanta, Hilton Hotel.The Atlanta University Center Robert W. Woodruff Library acknowledges the generous support of the Joseph & Evelyn Lowery Institute for Justice and Human Rights, the Joseph Echols Lowery Irrevocable Trust, and other donors in supporting the processing and digitization of Morehouse College's Joseph Echols and Evelyn Gibson Lowery Collection
Written on tape: Cernitin American. John Bellamy, John Ratliff, Larry Sparks.
No full textThis video features footage of introductions of representatives who work for Cernitin America Inc., a company that sold natural medicines. People introduced in the video include Bill Randolph, the vice president of field sales, Larry Sparks, the national training director, and John Bellamy, executive vice president of Dick Gregory Health Enterprises.The Atlanta University Center Robert W. Woodruff Library acknowledges the generous support of the Joseph & Evelyn Lowery Institute for Justice and Human Rights, the Joseph Echols Lowery Irrevocable Trust, and other donors in supporting the processing and digitization of Morehouse College's Joseph Echols and Evelyn Gibson Lowery Collection
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