title: The ima approach for the quick identification of the right recurrent laryngeal nerve in thyroid cancer surgery.
abstract: BACKGROUND
  The right recurrent laryngeal nerve (RLN) is more difficult to identify than the left RLN. The superior, lateral and inferior approaches are currently used to identify the RLN. This report presents a new technique, called the ima approach (the most inferior approach) for the quick identification of the right RLN.
  
  
  METHODS
  The ima approach involves dissection along the right common carotid artery and division of the most lateral branch of the inferior thyroid veins. The right RLN is identified at the bottom of the RLN triangle. This technique and the conventional inferior approach were applied to 81 and 19 patients with thyroid cancer, respectively.
  
  
  RESULTS
  The ima approach required a significantly shorter time in identifying the nerve than the inferior approach (9.6 ± 16.6 and 31.2 ± 24.4 s, respectively, p < 0.0001).
  
  
  CONCLUSIONS
  The ima approach is an easy, quick and safe technique for identifying the right RLN.
authors: Department of Surgery, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan. miyauchi@kuma-h.or.jp
authors: Akira
authors: A
authors: Miyauchi
authors: Hiroo
authors: H
authors: Masuoka
authors: Tomonori
authors: T
authors: Yabuta
authors: Mitsuhiro
authors: M
authors: Fukushima
authors: Minoru
authors: M
authors: Kihara
authors: Takuya
authors: T
authors: Higashiyama
authors: Yuuki
authors: Y
authors: Takamura
authors: Yasuhiro
authors: Y
authors: Ito
authors: Kaoru
authors: K
authors: Kobayashi
authors: Akihiro
authors: A
authors: Miya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012009:Recurrent Laryngeal Nerve; D061226:Recurrent Laryngeal Nerve Injuries / Q000209:etiology / Q000517:prevention & control*; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult