The risk of recurrent laryngeal nerve injury in thyroid surgery
Journal Title: Medpulse International Journal of Surgery - Year 2017, Vol 5, Issue 1
Abstract
Background: Incidence of RLN injury is expected to be higher with total thyroidectomy, though many clinical reports have shown that difference in incidence is insignificant after either total or subtotal thyroidectomy. So in the past the saying was 'if the nerve is seen it is damaged' and most surgeons used to avoid dissection in proximity of RLN Methodology: Along with routine laboratory investigations, USG of neck was performed in all patients, while FNAC was carried out, vocal cord function was evaluated by indirect laryngoscopy pre-operatively in all patients. Depending on the extent of resection of thyroid tissue, surgery was categorized as hemithyroidectomy, subtotal thyroidectomy, near total thyroidectomy and total thyroidectomy with routine identification of RLN in tracheao-esophageal groove, its relation with inferior thyroid artery and its branches examined and was then followed when it entered larynx Results: Thus the incidence for recurrent laryngeal nerve injury was 1.71% with respect to nerve at risk at 3% with respect to number of patients. Also these patients underwent more extensive dissection around the nerve Conclusion: Majority of nerve lesions are transient which shows recovery within six months of surgery. Definitive procedures for corrective treatment of RLN injury should not be considered for at least six months after surgery.
Authors and Affiliations
Padmanabh R Bhat, A V Kulakarni
Keywords
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