title: Retrograde thyroidectomy: a technique for visualization and preservation of the external branch of superior laryngeal nerve.
abstract: BACKGROUND
  The external branch of the superior laryngeal nerve (EBSLN) should be identified during thyroidectomy to prevent injury and post-operative voice change. Identification is rendered difficult during a standard thyroidectomy where there is a large gland with upper pole enlargement. We describe the retrograde thyroidectomy technique to facilitate nerve preservation.
  
  
  METHODS
  A retrograde thyroidectomy was performed in a 53-year old woman with a difficult goiter. Operative steps are described.
  
  
  CONCLUSIONS
  This technique allows the upper pole to be completely mobilized caudally providing unparalleled visualization of the upper pole vascular pedicle, thereby preserving the EBSLN.
  
  
  CONCLUSIONS
  There is better visualization of the superior thyroid pedicle and the EBSLN with retrograde thyroidectomy, potentially reducing the incidence of EBSLN injury during a difficult thyroidectomy.
authors: Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad and Tobago.
authors: Vijay
authors: V
authors: Naraynsingh
authors: Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad and Tobago. Electronic address: socawich@hotmail.com.
authors: Shamir O
authors: SO
authors: Cawich
authors: Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad and Tobago.
authors: Ravi
authors: R
authors: Maharaj
authors: Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad and Tobago.
authors: Dilip
authors: D
authors: Dan
keywords: Hoarseness; Ligament of Berry; Recurrent laryngeal nerve; Thyroidectomy; Voice