The recurrent laryngeal nerve and the Academy

August 2017 - Vol. 36, No. 7

Gregory W. Randolph, MD
AAO-HNS/F President

As otolaryngologists, it is our daily surgical challenge to offer complex head and neck surgery dovetailed with cranial nerve preservation. Submandibular gland resection and ramus preservation. Skull base neuro-otological surgery with seventh and eighth nerve preservation. Neck dissection and spinal accessory nerve preservation. Thyroid cancer surgery and recurrent laryngeal nerve preservation. The art of our surgery is the extirpation of cancer with cranial nerve preservation. This is what we, as otolaryngologists, do.

To paraphrase the 1724 account of Dr. Fulvio Gherli: The accident of hemorrhage is a minor evil … [but] the cutting of the laryngeal nerves [results in] loss for the rest of his life of the most beautiful prerogative given to man by God, which is la favella (speech) … but this danger can easily be avoided by that surgeon who with the provision of anatomy knows the site of these nerves.

We now have many tools to help us accomplish this goal—knowledge of anatomy, meticulous surgical technique, and neural monitoring. As Frank Lahey in 1938 wrote, “I am convinced the best management of RLN injuries is of the preventative character.”

As AAO-HNS/F president, I have initiated a new task force, Neural Monitoring for Head, Neck, and Thyroid Surgery. I have asked Joseph Scharpf, MD, to chair this important new task force, which will focus on the extra cranial seventh nerve/parotid surgery, vagus/ recurrent laryngeal nerve preservation during the thyroid surgery as well as spinal accessory and hypoglossal nerve preservation during head and neck surgery.

This will synergize with the Academy’s previous and highly productive Neural Monitoring Task Force, chaired by Sonya Malekzadeh, MD, focusing on seventh and eighth cranial nerves and neuro-otological surgery. Dr. Scharpf’s task force will include David L. Steward, MD, the incoming chair of the AAO-HNS Endocrine Surgery Committee, Catherine F. Sinclair, MBBS, member of the Women in Otolaryngology Section, Juliana Bonilla-Velez, MD, member of the Section for Residents and Fellows-in-Training (SRF), Whitney E. Liddy, MD, fellowship-trained endocrine surgeon, Jeffrey C. Liu, MD, head and neck surgeon and chair of the Young Physicians Section, and Michael C. Singer, MD, American Head and Neck Society Endocrine Section representative, as well as Lisa A. Orloff, MD, internationally known endocrine surgeon. I will serve as board liaison.

The task force will develop an AAO-HNS monitoring position statement, an Otolaryngology–Head and Neck Surgery journal summary paper, and other Academy/Foundation education products.

While our Academy focuses this significant organization and education activity on one branch of the vagus nerve, its activities are burgeoning and can be best appreciated by attending our Annual Meeting.

AAO-HNSF 2017 Annual Meeting  & OTO Experience
September 10-13, Chicago, IL

  • All full-conference attendees will receive unrestricted access to the Annual Meeting’s recordings as included in their registration. While not all sessions are eligible for AMA PRA Category 1 Credit™, total number of credits a participant can earn is 26.
  • All full-conference nonmember attendees will receive three months of complimentary membership.
  • Pre-conference workshops include: Endoscopic Ear Surgery: Friday, September 8
    Thyroid and Parathyroid Ultrasound Skills Workshop: Saturday, September 9
    Cutting-Edge Robotics in Laryngology and Otology Workshop: Saturday, September 9
  • Participate in the give back to Chicago program, Cradles to Crayons® Community Service, 11:00 am – 3:00 pm, Saturday, September 9
  • Contribute to the Academy’s Foundation through the 5K Run, 6:00 am – 7:00 am, Monday, September 11
  • Start your day with the Sunrise Yoga, 6:00 am – 7:00 am, Sunday, September 10
  • Network with your colleagues at the Presidents Reception, 6:00 pm – 7:30 pm, Sunday, September 10
  • All international attendees are invited to the International Reception, 8:00 pm – 10:00 pm, Tuesday, September 12
  • Learn about the future of medicine through Daniel Kraft, MD, Opening Ceremony keynoter
  • Most importantly, find your group! That may be Women in Otolaryngology (contact Ayesha N. Khalid, MD, WIO chair), Section for Residents and Fellows-in-Training (contact Peter M. Vila, MD, MSPH, SRF chair), Young Physician Section (contact Jeffrey Liu, MD, YPS chair), or come to one of the many Global Caucuses, including Africa, Middle East, or Europe (contact James E. Saunders, MD, international coordinator).

See you in Chicago!