scholarly journals Ipsilateral nonrecurrent laryngeal nerve palsy and delayed palsy of the contralateral recurrent laryngeal nerve in a case of third-time reoperative thyroid surgery

2019 ◽  
Vol 101 (2) ◽  
pp. e55-e58
Author(s):  
S Wijerathne ◽  
X Goh ◽  
R Parameswaran
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Nerve Palsy ◽  
Late Onset ◽  
Contralateral Side ◽  
Laryngeal Nerve ◽  
Aberrant Right Subclavian Artery ◽  
Appropriate Therapy ◽  
Nonrecurrent Laryngeal Nerve ◽  
Reoperative Thyroid Surgery

The occurrence of nonrecurrent laryngeal nerve and delayed nerve palsy of the contralateral nerve occurring simultaneously has never been described. A 67-year-old woman underwent reoperative completion thyroidectomy for enlarging thyroid nodules with recurrent hyperthyroidism and obstructive symptoms. Preoperative computed tomography of the neck showed a large compressive goitre with an aberrant right subclavian artery. At surgery, a type 1 nonrecurrent laryngeal nerve was found and inadvertently transected due to dense adhesions. It was repaired with ansa cervicalis graft. A fully preserved and functional recurrent laryngeal nerve was seen on the contralateral side at the end of surgery. However, the patient developed a delayed palsy on day 4 of the recurrent laryngeal nerve requiring a tracheostomy. Following successful speech and swallowing therapy, the patient was decannulated with good phonation and recovery of the left cord. Patients are at risk of bilateral nerve injury and late onset palsy in reoperative thyroid surgery. Management can be challenging and should be recognised to ensure appropriate therapy.

Predictive factors for recurrent laryngeal nerve palsy and hypoparathyroidism after thyroid surgery

2007 ◽  
Vol 32 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Y. Erbil ◽  
U. Barbaros ◽  
H. İşsever ◽  
İ. Borucu ◽  
A. Salmaslıoğlu ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Predictive Factors ◽  
Thyroid Surgery ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Palsy

scholarly journals Assessment of morbidity and mortality of thyroid surgery

2017 ◽  
Vol 6 (2) ◽  
pp. 15-19
Author(s):  
Md Mostafizur Rahman ◽  
SM Golam Rabbani ◽  
Md Abdur Rashid ◽  
M Alamgir Chowdhury ◽  
Fatema Nihar ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Surgical Techniques ◽  
Laryngeal Nerve ◽  
Morbidity And Mortality ◽  
Medical College ◽  
Laryngeal Nerve Palsy ◽  
Management Of Complications

Background: To find out the incidence and types of complications after thyroidectomy.To analyze the factors related to the complications of thyroid surgery.Material and method: The study was carried out at Shahid Suhrawardy medical college and Hospital, Dhaka from July 2007 to June 2008. Fifty patients were selected for the study who were treated by thyroidectomy. The mean patient's age at the time of surgery was 41.9±8.1 years ranged from 10 to 60 years. Data were collected in a prescribed data collection sheet. Then all data were compiled and analyzed.Result: 12% of the patients had transient hypoparathyroidism, 4% had haemorrhage, 2% had permanent hypoparathyroidism, 4% had temporary recurrent laryngeal nerve (RLN) palsy and 2% had permanent recurrent laryngeal nerve palsy. Other rare complications were superior laryngeal nerve palsy, hematoma, and wound infection.Conclusion: Improved surgical techniques and proper management of complications reduce the postoperative morbidity and mortality of thyroid surgery. In spite of all measures, keen observation in postoperative period is very important to find out the complications for early intervention.Anwer Khan Modern Medical College Journal Vol. 6, No. 2: July 2015, P 15-19

scholarly journals Complications of Thyroid Surgery & Their Risk Factors: A Prospective Study at a Tertiary Care Center of Eastern Nepal

2019 ◽  
Vol 2 (1) ◽  
pp. 25-33
Author(s):  
Niranjan Panthi ◽  
S T Chettri ◽  
S P Shah ◽  
D Poudel ◽  
S Manandhar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Recurrent Laryngeal Nerve ◽  
Neck Dissection ◽  
Thyroid Surgery ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Central Compartment ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Palsy

Background: Thyroid surgery is one of the commonest surgeries performed by otolaryngologists. Currently, the main postoperative complications are hypocalcemia and recurrent laryngeal nerve (RLN) palsy. Extent of surgery, lack of identification of RLN/ parathyroid glands, malignancy, central compartment neck dissection, lateral neck dissection, previous surgery and size of goiter are the risk factors for complications. The objectives of this study were to determine the frequency of postoperative complications after thyroid surgery and to analyze the risk factors of complications. Methods: It was a prospective study of 45 patients undergoing thyroid surgery in eastern Nepal from March 2014 to September 2015. The postoperative complications and the risk factors associated with these complications were evaluated. Results: There were total of 45 cases of thyroid surgery, with the mean age of 39.04 years. The main postoperative complications were: hypocalcaemia (6 or 13.33% cases) and vocal cord palsy due to recurrent laryngeal nerve injury (5 or 11.11% cases). Temporary hypocalcaemia was observed in 3(6.67%) cases while permanent hypocalcaemia developed in other 3 (6.67%) cases. Similarly, the temporary and permanent recurrent laryngeal nerve palsy occurred in 3 (6.67%) cases and 2 (4.44%)cases respectively. The risk factors associated with hypocalcaemia were: malignancy, repeat operation, central compartment neck dissection and non-identification of parathyroid glands during surgery. Similarly, recurrent laryngeal nerve palsy was observed in cases of malignancy and central compartment neck dissection. Conclusion: The major postoperative complications of thyroid surgery were hypocalcaemia and recurrent laryngeal nerve palsy. Malignancy and central compartment neck dissection had effect on incidence of complications. Sound knowledge of anatomy and meticulous surgical technique are needed to reduce the incidence of complications.

scholarly journals A Comparative Study on Functional Status of Recurrent Laryngeal Nerve with or without Exploration of the Nerve during Thyroid Surgery in a Tertiary Care Centre of Eastern India

2021 ◽  
Vol 8 (13) ◽  
pp. 768-772
Author(s):  
Nabanita Mandal ◽  
Atish Haldar ◽  
Ranjan Paul
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Functional Status ◽  
Thyroid Surgery ◽  
Nerve Palsy ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Surgical Techniques ◽  
Laryngeal Nerve ◽  
Care Centre ◽  
Tertiary Care Centre

BACKGROUND From the last century to modern days, there has been a paradigm shift in the field of thyroid surgery. Initially what was a dreadful surgery with multi fold serious complications, now with the advent of modern surgical technique (bipolar to nerve monitoring & emerging use of microscope), and better knowledge of anatomy, it has become one of the most frequently performed surgeries worldwide with very few complications. In spite of all these, postoperative complications like recurrent laryngeal nerve (RLN) palsy is still mostly feared by surgeons and still is one of the most frequent complications. METHODS This was a prospective nonrandomised controlled trial conducted among 60 study participants in the Department of Otorhinolaryngology and Head & Neck Surgery, of a tertiary care centre in West Bengal from July 2016 to June 2018. In this study two different surgical techniques were applied in two patient groups. In one group subcapsular dissection of thyroid gland was done without exploration of recurrent laryngeal nerve course in neck; and in another group, the complete course of the aforesaid nerve in the neck was explored and preserved. The postoperative functional status of RLN was assessed by fibreoptic laryngoscopy immediately after recovery from anaesthesia and in postoperative follow ups. We wanted to compare the outcome (in terms of functional status of RLN) in these two groups. RESULTS 3 patients (10 % cases) of nerve palsy were seen among 30 patients of subcapsular dissection group, whereas only one case (3.3 %) of nerve palsy was seen amongst 30 cases of complete exploration of recurrent laryngeal nerve. CONCLUSIONS Thyroidectomy with meticulous exploration of the recurrent laryngeal nerve was found to be a superior method as compared to the subcapsular dissection. KEYWORDS Recurrent Laryngeal Nerve, Subcapsular Dissection, Complete Exploration, Thyroidectomy

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