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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Anaesthetic management of transoral endoscopic thyroidectomy. A case report
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Vol. 68. Issue 3.
Pages 149-152 (March 2021)
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Vol. 68. Issue 3.
Pages 149-152 (March 2021)
Case report
Anaesthetic management of transoral endoscopic thyroidectomy. A case report
Manejo anestésico de la tiroidectomía endoscópica transoral. Reporte de un caso
M. Bermúdez-Trianoa,
Corresponding author
macbertri@gmail.com

Corresponding author.
, G. Fernández-Castellanoa, R. Guerrero-Domíngueza, J.L. López-Romerob, I. Benítez-Lineroa
a Anestesiología y Reanimación, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain
b Unidad de Gestión Clínica de Anestesiología y Reanimación, Hospital General Virgen del Rocío, Sevilla, Spain
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Abstract

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a novel andminimally invasive procedure, free of visible scars and showing encouraging results in termsof rapid recovery and less postoperative pain. It consists of performing the thyroidectomythrough its natural orifice, using three ports in the oral vestibular area and carrying out acareful dissection to the sternal notch and the edges of both sternocleidomastoid muscles.

The objective of this article is to describe the different anesthetic implications that thissurgical technique entails, given that the evidence published to date in the literature is very limited. It is considered essential to control the recurrent laryngeal nerve using an endotrachealtube with electromyography to ensure its identification and integrity, as well as the use of othermonitors such as the TOF watch or the bispectral index to ensure adequate anesthetic depthand an optimal level of muscle relaxation.

Keywords:
Tiroidectomía endoscópica transoral
Anestesia
Neuromonitorización
Nervio laríngeo recurrente
Tubo endotraqueal con electromiografía
Resumen

La tiroidectomía endoscópica transoral por abordaje vestibular (TOETVA) constituyeun procedimiento novedoso y mínimamente invasivo, libre de cicatrices visibles y que presentaresultados alentadores en cuanto a la rápida recuperación y menor dolor posoperatorio. Consisteen realizar la tiroidectomía a través de su orificio natural, empleando tres puertos en el áreaoral vestibular y llevando a cabo una disección cuidadosa hasta la muesca esternal y los bordesde ambos músculos esternocleidomastoideos.

El objetivo es describir las diferentes implicaciones anestésicas que conlleva esta técnicaquirúrgica, dado que la evidencia publicada hasta la fecha en la literatura es muy limitada.Se considera esencial la monitorización del nervio laríngeo recurrente mediante tubo endotra-queal con electromiografía para garantizar su identificación e integridad, así como la utilizaciónde otros monitores como el TOF-watch o el índice biespectral para asegurar una adecuadaprofundidad anestésica y un óptimo nivel de relajación muscular.

Palabras clave:
Transoral Endoscopic Thyroidectomy
Anaesthesia
Neuromonitoring
Recurrent laryngeal nerve
Electromyographic endotracheal tube

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