title: Management of the exterior branch of the superior laryngeal nerve among thyroid surgeons - Results from a nationwide survey.
abstract: BACKGROUND
  The external branch of the superior laryngeal nerve is important for the voice. However, it is unknown how thyroid surgeons manage this nerve during operations. We hypothesised that this management is related to the surgeon's age, gender, the surgeons' annual number of thyroid operations, i.e volume, and surgical specialisation.
  
  
  METHODS
  We sent a 17-item enquiry by e-mail to members of the Swedish Endocrine Surgical Society and the Swedish Association for Otorhinolaryngology--Head and Neck Surgery. The questions covered subjects such as age, gender, type of department and operation volume of the surgeon, and whether and how the surgeon would try to preserve and/or identify the EBSLN during an operation. Surgeons were asked to rate the importance of the nerve, and of their use of laryngoscopy and/or voice recording.
  
  
  RESULTS
  There were 85 respondents. Ninety per cent of them would always or often try to preserve the nerve, but only half would always or often try to identify it. Endocrine surgeons more often stated that they would preserve the nerve; they rated its importance more highly and they more often mentioned the use of neuromonitoring to identify the nerve, than head and neck surgeons. Head and neck surgeons on the other hand were more likely to perform laryngoscopy. Endocrine surgeons more often performed >50 thyroid operations per year than head and neck surgeons.
  
  
  CONCLUSIONS
  Management of the external branch of the superior laryngeal nerve differed according to surgeon specialisation, which in turn was associated with surgical volume.
authors.affiliation: Dept. of Surgery, Lund University Hospital, Lund University, Lund, Sweden. Electronic address: martin.almquist@med.lu.se.
authors.forename: Martin
authors.initials: M
authors.lastname: Almquist
authors.affiliation: Dept. of Surgery, Lund University Hospital, Lund University, Lund, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Nordenström
mesh_terms: D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D061224:Laryngeal Nerve Injuries / Q000517:prevention & control*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D013043:Specialties, Surgical; D066231:Surgeons; D013961:Thyroid Gland / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods*
keywords: External branch of the superior laryngeal nerve (EBSLN); Questionnaire; Surgery; Survey; Thyroid