This innovation could cut the amount of malpractice lawsuits against thyroid surgeons

Using a human amniotic membrane for protection and healing can lead to a 50 percent reduction in vocal cord nerve injuries that can result from surgery of the thyroid and parathyroid glands, a study published in Cell Transplantation suggests.

The study, conducted by surgeons at the Clayman Thyroid Center and Norman Parathyroid center at the Hospital for Endocrine Surgery in Tampa, Fla., found similar reductions in the incidence, severity and duration of vocal cord injuries. The study included more than 300 patients, Clayman Thyroid Center said Feb. 3.

"This type of nerve injury, including even short-term vocal dysfunction, has a tremendous impact on patients' physical and psychosocial well-being," said lead author Gary Clayman, MD, DMD. "Until now, there was nothing a surgeon could do to decrease the likelihood of this terrible complication from happening. The use of amniotic membrane in these patients represents a significant unmet medical need which should be adopted quickly by other neck surgeons."

Vocal cord nerve injury is the most common cause for malpractice suits against surgeons performing thyroid and parathyroid surgery, Clayman Thyroid said in a news release.

Authors of the study said the amniotic membrane's benefit is likely two-fold: a physical barrier to scarring, and a biologic effect owing to the numerous growth factors and inflammatory mediators the membranes are known to harbor.

The researchers said the findings may benefit patients undergoing other procedures, such as anterior cervical spine and esophagus surgery. "Although this study was conducted in thyroid surgery patients only, it is the exact same injury that can occur in all neck surgeries, thus we expect all surgeons who operate in the neck will eventually adopt this method of vocal cord nerve protection," co-author James Norman, MD, said.

Dr. Clayman said the results were so impressive the practice is now standard on all applicable thyroid and parathyroid procedures at the Hospital for Endocrine Surgery.

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