Management of Post-extubation Stridor Following Total Thyroidectomy Due to Bilateral Recurrent Laryngeal Nerve Paresis - A Case Report

Author(s):  
Hassaan Muhammed ◽  
M. B. Priyadarshini
2015 ◽  
Vol 7 (1) ◽  
pp. 14-16
Author(s):  
Krishnan Ravikumar ◽  
Dhalapathy Sadacharan

ABSTRACT Introduction A nonrecurrent course is an unusual anatomic variation of the recurrent laryngeal nerve. It is seen usually on the right side, and it is very rare on the left side. Nonrecurrent laryngeal nerve if present is mostly associated with vascular anomalies. Case report A 55-year-old female was referred to us with thyrotoxic symptoms for a period of 6 months. She was rendered euthyroid with antithyroid medications. After complete evaluation, she was posted for total thyroidectomy. Intraoperatively, right recurrent nerve could not be identified in usual position. On careful dissection, a nonrecurrent laryngeal nerve was identified. The recurrent laryngeal nerve on the left side showed normal course. The intraoperative and postoperative period were uneventful. Postoperative vocal cord status was normal. Conclusion This case was presented for its rarity and to stress the need for orderly meticulous surgical dissection. How to cite this article Ravikumar K, Sadacharan D, Suresh Rv. Surgical Delight: Nonrecurrent Laryngeal Nerve. World J Endoc Surg 2015;7(1):14-16.


2014 ◽  
Vol 13 (2) ◽  
pp. 23-24 ◽  
Author(s):  
D.N. Goyal ◽  
◽  
Venkateswara Rao Katta ◽  
Vijay Kumar V.R.N ◽  
Sumeera Farhath ◽  
...  

2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Prashant Bhatt ◽  
Apar Pokharel

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.


1980 ◽  
Vol 45 (3) ◽  
Author(s):  
Frank B. Wilson ◽  
D. J. Oldring ◽  
Kathleen Mueller

On page 112 of the report by Wilson, Oldring, and Mueller ("Recurrent Laryngeal Nerve Dissection: A Case Report Involving Return of Spastic Dysphonia after Initial Surgery," pp. 112-118), the paraphrase from Cooper (1971), "if the patients are carefully selected and are willing to remain in therapy for a long period of time," was inadvertantly put in quotation marks.


2018 ◽  
Vol 6 (1) ◽  
pp. 11-14
Author(s):  
Deepak Yadav ◽  
Bhawana Dangol ◽  
Anita GC ◽  
Namita Shrestha ◽  
Ishwor Raj Devkota ◽  
...  

Objective: To assess the outcome of thyroid surgeries at Patan HospitalMaterials and Methods: It is a retrospective study of in-patient records of patients undergoing thyroid surgeries for various indications from April 2013 to January 2015 at Patan Hospital, Lalitpur.Results: During the period of 21 months, 75 patients underwent thyroid surgeries. Majority of patients underwent hemithyroidectomy (35) followed by total thyroidectomy (28), subtotal thyroidectomy (7) and completion thyroidectomy (5). Out of 28 patients undergoing total thyroidectomy (TT), 11 underwent central compartment clearance (CCC), 5 underwent CCC and lateral neck dissection. Among 5 patients undergoing completion thyroidectomy, CCC was performed in all cases and in one patient lateral neck dissection was also performed.  A total of 13 patients developed unilateral recurrent laryngeal nerve palsy (RLN), among them 5 had permanent palsy. Tracheostomy had to be done in immediate postoperative period for stridor following total thyroidectomy (TT) in one case. Temporary hypocalcaemia was observed in 10 (10/28) cases following TT, out of which 8 had undergone CCC. Permanent hypocalcaemia was observed in 7 (7/28) cases following TT out of which 3 had undergone CCC. Chylous leak occurred in one of the patient undergoing left level II-IV neck dissection which was managed conservatively. None of the patient had to be transfused postoperatively.Conclusion: Complications to thyroid surgery are not uncommon. Visualization of recurrent laryngeal nerve alone in our context is adequate in experienced hands. Identification of parathyroid during thyroidectomy is recommended to avoid hypocalcaemia. Meticulous dissection can reduce the complications.Nepalese Journal of ENT Head and Neck Surgery, Vol. 6, No. 1, 2015


2021 ◽  
Vol 28 (1) ◽  
pp. 7-12
Author(s):  
Lucian ALECU ◽  
◽  
Iulian SLAVU ◽  
Adrian TULIN ◽  
Vlad BRAGA ◽  
...  

Introduction: Recurrent laryngeal nerve damage during total thyroidectomy was, is, and probably will be in the near future the Achilles’ heel of total thyroidectomy. Material and method: To perform the research we used the PubMed database. The questions were conceived to respect the PICOS guidelines. The PRISMA checklist was used to filter the results. The search was structured following the words: „recurrent laryngeal nerve injury” AND „total thyroidectomy”. Results: A total of 60 papers were identified. We excluded 12 papers as they were duplicates. From the 48 papers left, another 4 could not be obtained. Another 3 papers from the 44 left were excluded due to the fact they were not written in English. One paper was excluded as the subject did not follow our research purpose. 40 papers were left for analysis and discussion. Conclusion: To prevent recurrent laryngeal nerve lesions, at the moment in the literature there is no consensus. Unintentional injury to the recurrent laryngeal nerve is predictable but not an avertible situation thus bilateral lesions still represent a dramatic situation across the world for the patients and the operating surgeon.


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