title: Is the superior laryngeal nerve really safe when using harmonic focus in total thyroidectomy? A prospective randomized study.
abstract: BACKGROUND
  Harmonic focus (HF) was introduced in thyroid surgery in an effort to reduce operation time and complications.
  
  
  OBJECTIVE
  The present study aimed to compare function of superior laryngeal nerve and incidence of other postoperative complications in total thyroidectomies using HF and conventional ligation (CL).
  
  
  METHODS
  The trial is a randomized single-center, single-blinded study. Patients aged ≥ 18 years scheduled for total thyroidectomy were considered for participation. An ultrasonic dissector was used for coagulation and cutting in the HF group, while the standard technique was used in the CL group. Demographic, surgical data, and complications were recorded. Data were analyzed using SPSS for Windows.
  
  
  RESULTS
  Of 244 eligible patients, data of 206 patients who completed the study were analyzed. The groups were similar in terms of age, sex, and indication for operation. The mean operative time in the HF group was significantly shorter than that in CL group (p=0.01). Drain necessity, duration of drainage, duration of postoperative hospitalization, and the incidence of postoperative complications was similar in the groups (p>0.05). The external branch of the superior laryngeal nerve and recurrent laryngeal nerve palsy were noted in three and two patients in the HF group and in two and one patients in the CL group at 6 months.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first study comparing conventional technique with HF in total thyroidectomy, focusing on the function of the external branch of the superior laryngeal nerve using laryngostroboscopy; results showed that HF is as safe as the conventional technique.
authors.affiliation: Department of General Surgery, Sağlık Bilimleri University, Konya Training and Research Hospital, Turkey. Electronic address: arslanka74@hotmail.com.
authors.forename: Kemal
authors.initials: K
authors.lastname: Arslan
authors.affiliation: Department of General Surgery, Sağlık Bilimleri University, Konya Training and Research Hospital, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Erenoglu
authors.affiliation: Department of General Surgery, Sağlık Bilimleri University, Konya Training and Research Hospital, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Dogru
authors.affiliation: Department of Otorhinolaryngology, Konya Training and Research Hospital, Konya, Turkey.
authors.forename: Gultekin
authors.initials: G
authors.lastname: Ovet
authors.affiliation: Department of General Surgery, Sağlık Bilimleri University, Konya Training and Research Hospital, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Turan
authors.affiliation: Department of General Surgery, Sağlık Bilimleri University, Konya Training and Research Hospital, Turkey.
authors.forename: Arif
authors.initials: A
authors.lastname: Atay
authors.affiliation: Department of General Surgery, Sağlık Bilimleri University, Konya Training and Research Hospital, Turkey.
authors.forename: Hande
authors.initials: H
authors.lastname: Koksal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D061224:Laryngeal Nerve Injuries / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D007823:Laryngeal Nerves / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D016037:Single-Blind Method; D013965:Thyroidectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D059708:Ultrasonic Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D055815:Young Adult
keywords: harmonic focus; superior laryngeal nerve; thyroidectomy