Recurrent laryngeal nerve injury during thyroid surgery

Authors

  • Asaad Mohammed kadhim General Surgeon in Alfayha Hospital and Lecturer in Basra University
  • Abdulameer Mohsen Aldarajy General Surgeon in Alfayha Hospital /Basra/Iraq

Abstract

Iatrogenic injury of the recurrent laryngeal nerve (RLN) which frequently leads to vocal cord paresis or paralysis  is one of the main problems in thyroid surgery. The incidence of recurrent laryngeal nerve palsy varies between    1.5-14%. A total of 100 patients were included in this retrospective study. All patient  underwent thyroidectomy  at  Al Fayhaa General Hospital  from 1st April 2003 to 1st April 2004. Transient unilateral vocal cord paralysis occurred in 7 (4.06%) While permanent paralysis was found in only one patient (0.58%). There was  significant increases in the incidence of  transient  RLN injury in total and near total thyroid lobectomy. There were no  significant increases in the incidence of  permanent  RLN injury in malignant tumors

References

- Bergamaschi R, Becouarn G, Ronceray J, Arnaud JP. Morbidity of thyroid surgery. Am J Surg 1998. Jul;176(1):71-75.10.1016/S0002-9610(98)00099-3 [PubMed] [Cross Ref]

- Jatzko GR, Lisborg PH, Müller MG, Wette VM. Recurrent nerve palsy after thyroid operations–principal nerve identification and a literature review. Surgery 1994. Feb;115(2):139-144. [PubMed]

- Fewins J, Simpson CB, Miller FR. Complications of thyroid and parathyroid surgery. Otolaryngol Clin North Am 2003. Feb;36(1):189-206, x.10.1016/S0030-6665(02)00129-9 [PubMed] [Cross Ref]

- Hisham AN, Lukman MR. Recurrent laryngeal nerve in thyroid surgery: a critical appraisal. ANZ J Surg 2002. Dec;72(12):887-889.10.1046/j.1445-2197.2002.02578.x [PubMed] [Cross Ref]

- Kasemsuwaran L, Nubthuenetr SJ. Recurrent laryngeal nerve paresis: a complication of thyroidectomy. Otorhinolaryngology 1997;26:365-367. [PubMed]

- Gavilán J, Gavilán C. Recurrent laryngeal nerve. Identification during thyroid and parathyroid surgery. Arch Otolaryngol Head Neck Surg 1986. Dec;112(12):1286-1288. [PubMed]

- Sosa JA, Bowman HM, Tielsch JM, Powe NR, Gordon TA, Udelsman R. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg 1998. Sep;228(3):320-330.10.1097/00000658-199809000-00005 [PMC free article] [PubMed] [Cross Ref

- Lamadé W, Renz K, Willeke F, Klar E, Herfarth C. Effect of training on the incidence of nerve damage in thyroid surgery. Br J Surg 1999. Mar;86(3):388-391.10.1046/j.1365-2168.1999.01017.x [PubMed] [Cross Ref]

- Delbridge L. Total thyroidectomy: the evolution of surgical technique. ANZ J Surg 2003. Sep;73(9):761-768.10.1046/j.1445-2197.2003.02756.x [PubMed] [Cross Ref]

- Mishra A, Agarwal G, Agarwal A, Mishra SK. Safety and efficacy of total thyroidectomy in hands of endocrine surgery trainees. Am J Surg 1999. Nov;178(5):377-380.10.1016/S0002-9610(99)00196-8 [PubMed] [Cross Ref]

- Snyder SK, Lairmore TC, Hendricks JC, Roberts JW. Elucidating mechanisms of recurrent laryngeal nerve injury during thyroidectomy and parathyroidectomy. J Am Coll Surg 2008. Jan;206(1):123-130.10.1016/j.jamcollsurg.2007.07.017 [PubMed] [Cross Ref]

- Witte J, Simon D, Dotzenrath C. Recurrent nerve palsy and hypocalcemia after surgery of benign thyroid disease. Acta Chir Austria 1996;28:361-364.10.1007/BF02616290 [Cross Ref]

- Sancho JJ, Pascual-Damieta M, Pereira JA, Carrera MJ, Fontané J, Sitges-Serra A. Risk factors for transient vocal cord palsy after thyroidectomy. Br J Surg 2008. Aug;95(8):961-967.10.1002/bjs.6173 [PubMed] [Cross Ref]

- Woodson GE. Spontaneous laryngeal reinnervation after recurrent laryngeal or vagus nerve injury. Ann Otol Rhinol Laryngol 2007. Jan;116(1):57-65. [PubMed]

- Randolph GW, Kobler JB, Wilkins J. Recurrent laryngeal nerve identification and assessment during thyroid surgery: laryngeal palpation. World J Surg 2004. Aug;28(8):755-760.10.1007/s00268-004-7348-x [PubMed] [Cross Ref]

- Chaudhary IA, Samiullah MR, Masood R, Majrooh MA, Mallhi AA. Recurrent laryngeal nerve injury: an experience with 310 thyroidectomies. J Ayub Med Coll Abbottabad 2007. Jul-Sep;19(3):46-50. [PubMed]

- Aytac B, Karamercan A. Recurrent laryngeal nerve injury and preservation in thyroidectomy. Saudi Med J 2005. Nov;26(11):1746-1749. [PubMed]

- Eisele DW. Intraoperative electrophysiologic monitoring of the recurrent laryngeal nerve. Laryngoscope 1996. Apr;106(4):443-449.10.1097/00005537-199604000-00010 [PubMed] [Cross Ref]

- Acun Z, Cinar F, Cihan A, Ulukent SC, Uzun L, Ucan B, et al. Importance of identifying the course of the recurrent laryngeal nerve in total and near-total thyroid lobectomies. Am Surg 2005. Mar;71(3):225-227. [PubMed]

- Bailleux S, Bozec A, Castillo L, Santini J. Thyroid surgery and recurrent laryngeal nerve monitoring. J Laryngol Otol 2006. Jul;120(7):566-569.10.1017/S0022215106000946 [PubMed]

- Canbaz H, Dirlik M, Colak T, Ocal K, Akca T, Bilgin O, et al. Total thyroidectomy is safer with identification of recurrent laryngeal nerve. J Zhejiang Univ Sci B 2008. Jun;9(6):482-488.10.1631/jzus.B0820033 [PubMed]

- Mutlu D, Ramazan M. Factors Effecting Recurrent Laryngeal nerve Injury after thyroid gland surgery. Turkiye Klinikleri J Med Sci. 1999;19:193-199.

- Richmond BK, Eads K, Flaherty S, Belcher M, Runyon D. Complications of thyroidectomy and parathyroidectomy in the rural community hospital setting. Am Surg 2007. Apr;73(4):332-336. [PubMed]

- Hermann M, Keminger K, Kober F. Risk factors of recurrent nerve palsy: a statistical analysis of 7566 thyroid operations. Chirurgie 1991;62:182-188. [PubMed]

- Echternach M, Maurer CA, Mencke T, Schilling M, Verse T, Richter B. Laryngeal complications after thyroidectomy: is it always the surgeon? Arch Surg 2009. Feb;144(2):149-153, discussion 153.10.1001/archsurg.2008.530 [PubMed }

- Dimov RS, Doikov IJ, Mitov FS, Deenichin GP, Yovchev IJ. Intraoperative identification of recurrent laryngeal nerves in thyroid surgery by electrical stimulation. Folia Med (Plovdiv) 2001;43(4):10-13. [PubMed]

- Marcus B, Edwards B, Yoo S, Byrne A, Gupta A, Kandrevas J, et al. Recurrent laryngeal nerve monitoring in thyroid and parathyroid surgery: the University of Michigan experience. Laryngoscope 2003. Feb;113(2):356-361.10.1097/00005537-200302000-00028[PubMed]

- Douglas W.,Laurence Y,Alden H,James W,Thyroid and parathyroid procedures In ACS principles and practice 2003,p 602

- Sista F, Schietroma M, Ruscitti C, De Santis G, De Vita F, Carlei F, Amicucci G.J Laparoendosc 1New ultrasonic dissector versus conventional hemostasis in thyroid surgery: a randomized prospective study. Adv Surg Tech A. 2012 Apr;22(3):220-4. doi: 10.1089/lap.2011.0266. Epub 2012 Mar 6.

- Friedrich T1, Steinert M, Keitel R, Sattler B, Schönfelder M. [Incidence of damage to the recurrent laryngeal nerve in surgical therapy of various thyroid gland diseases--a retrospective study]. Zentralbl Chir. 1998;123(1):25-9 .

Downloads

Published

2021-03-03

Issue

Section

ARTICLE