scholarly journals Bilateral Recurrent Laryngeal Nerve Palsy following Total Thyroidectomy in Triple A Syndrome, an Unexpected but Critical Complication

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Mathieu Chamberland ◽  
Marc-Antoine Poulin ◽  
Danielle Beaudoin
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
White Male ◽  
Laryngeal Nerve ◽  
Neurological Involvement ◽  
Triple A Syndrome ◽  
Laryngeal Nerve Palsy ◽  
Disease Case

Introduction. Triple “A” syndrome (TAS) is a rare autosomal recessive disorder that presents in childhood with achalasia cardia, alacrima, ACTH-resistant adrenal insufficiency, with sensorimotor and autonomic polyneuropathy developing later in the course of the disease. Case Presentation. An adult white male affected by this syndrome underwent an uneventful total thyroidectomy for malignancy and suffered delayed bilateral recurrent laryngeal nerve palsy in the early postoperative hours. The palsy spontaneously resolved after a five-week course. Conclusion. Given the rarity of this severe condition and the absence of surgical or medical causes identifiable, there is possibility that it is the neurological involvement caused by TAS that predisposed the patient to this adverse outcome, precipitated by standard manipulations during surgery.

Total thyroidectomy for safe and definitive management of Graves' disease

2013 ◽  
Vol 127 (7) ◽  
pp. 681-684 ◽  
Author(s):  
A Prasai ◽  
P A Nix ◽  
M Aye ◽  
S Atkin ◽  
R J England
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Definitive Treatment ◽  
Royal Infirmary ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy

AbstractBackground:The role of total thyroidectomy in the management of patients with Graves' disease remains controversial. However, there is increasing evidence to support the role of the procedure as a safe and definitive treatment for Graves' disease.Method:Patients were identified from a prospective thyroid database of the multidisciplinary thyroid clinic at Hull Royal Infirmary. All case notes were independently reviewed to confirm the data held on the database.Results:Over a 7-year period, the senior author has performed 206 total thyroidectomies for Graves' disease. The incidence of temporary recurrent laryngeal nerve palsy and hypoparathyroidism was 3.4 per cent and 24 per cent respectively. There was one case of permanent unilateral recurrent laryngeal nerve palsy, and 3.9 per cent of patients developed permanent hypoparathyroidism. There has been no relapse of thyrotoxicosis.Conclusion:In the context of a multidisciplinary thyroid clinic, total thyroidectomy should be offered as a safe and effective first-line treatment option for Graves' disease.

Value of intra-operative neuromonitoring of the recurrent laryngeal nerve in total thyroidectomy for benign goitre

2015 ◽  
Vol 129 (6) ◽  
pp. 553-557 ◽  
Author(s):  
C Page ◽  
P Cuvelier ◽  
A Biet ◽  
V Strunski
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Control Group ◽  
Laryngeal Nerve Palsy ◽  
Significant Difference ◽  
Patient Groups ◽  
The Impact

AbstractObjective:This study aimed to evaluate the impact of intra-operative neuromonitoring of the recurrent laryngeal nerve during total thyroidectomy for benign goitre.Methods:A single-centre retrospective study using historical controls was conducted for a 10-year period, comprising a series of 767 patients treated by total thyroidectomy for benign goitre. Of these, 306 had intra-operative neuromonitoring of the recurrent laryngeal nerve and 461 did not. Post-operative laryngeal mobility was assessed in all patients by direct laryngoscopy before hospital discharge and at post-operative follow-up visits.Results:In all, 6 out of 461 patients (1.30 per cent) in the control group and 6 out of 306 patients (1.96 per cent) in the intra-operative neuromonitoring group developed permanent recurrent laryngeal nerve palsy. No statistically significant difference was observed between the two patient groups.Conclusion:Intra-operative neuromonitoring does not appear to affect the post-operative recurrent laryngeal nerve palsy rate or to reliably predict post-operative recurrent laryngeal nerve palsy. However, it can accurately predict good nerve function after thyroidectomy.

scholarly journals Delayed Recurrent Laryngeal Nerve palsy following total thyroidectomy: A case report

2014 ◽  
Vol 13 (2) ◽  
pp. 23-24 ◽  
Author(s):  
D.N. Goyal ◽  
◽  
Venkateswara Rao Katta ◽  
Vijay Kumar V.R.N ◽  
Sumeera Farhath ◽  
...  
Keyword(s):  
Case Report ◽  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Palsy

scholarly journals Bilateral Adductor Nerve Palsy Following Total Thyroidectomy: A Case Report

2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Prashant Bhatt ◽  
Apar Pokharel
Keyword(s):  
Case Report ◽  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Female Patient ◽  
Nerve Palsy ◽  
Rare Complication ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Clinical Findings ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Palsy

Recurrent Laryngeal Nerve palsy following thyroidectomy is usually attributed to surgery whereas sometimes the cause can be non-surgical and can result in adductor palsy. Bilateral Recurrent Laryngeal Nerve (RLN) paralysis is a rare complication of thyroidectomy. We present a 35 years female patient who developed dysphonia due to bilateral adductor RLN palsy following total thyroidectomy. The clinical findings and recovery were suggestive of a non-surgical cause for palsy in this patient. The management of these patients differs and the knowledge in this regard is very important for the surgeons. Tracheostomy is not required, and recovery of the nerve occurs in most cases in adductor palsy.

scholarly journals Bilateral Adductor Palsy: A Rare Complication during Routine Surgery

2013 ◽  
Vol 5 (3) ◽  
pp. 76-78
Author(s):  
Vidya Bhushan Rangappa ◽  
Athira Ramakrishnan ◽  
Raja Ram
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Unusual Case ◽  
Rare Complication ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Palsy

ABSTRACT Recurrent laryngeal nerve (RLN) palsy occurring following thyroidectomy is a known complication. The first thing that comes to the surgeons, mind in a case of bilateral recurrent laryngeal nerve palsy is tracheostomy to secure the airway. But here we present a very interesting and unusual case of bilateral adductor palsy, post total thyroidectomy. We also highlight on the fact that not always the surgeon is to be blamed and there are certain subtle other factors to be aware of. How to cite this article Rangappa VB, Ramakrishnan A, Balasubramanya AM, Ram R. Bilateral Adductor Palsy: A Rare Complication during Routine Surgery. World J Endoc Surg 2013;5(3):76-78.

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy ◽  
Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

Brachial plexus neuritis and recurrent laryngeal nerve palsy

1988 ◽  
Vol 235 (5) ◽  
pp. 323-323 ◽  
Author(s):  
E. A. C. M. Sanders ◽  
V. M. H. Van den Neste ◽  
T. U. Hoogenraad
Keyword(s):  
Brachial Plexus ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Palsy ◽  
Brachial Plexus Neuritis
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