scholarly journals A current view on recurrent laryngeal nerve injury in total thyroidectomy

2021 ◽  
Vol 28 (1) ◽  
pp. 7-12
Author(s):  
Lucian ALECU ◽  
◽  
Iulian SLAVU ◽  
Adrian TULIN ◽  
Vlad BRAGA ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Injury ◽  
Unintentional Injury ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Current View ◽  
Pubmed Database ◽  
Laryngeal Nerve Injury ◽  
The Moment

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.

Importance of Identifying the Course of the Recurrent Laryngeal Nerve in Total and Near-Total Thyroid Lobectomies

2005 ◽  
Vol 71 (3) ◽  
pp. 225-227
Author(s):  
Zeki Acun ◽  
Fikret Cinar ◽  
Alper Cihan ◽  
Suat Can Ulukent ◽  
Lokman Uzun ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Injury ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Thyroid Diseases ◽  
Thyroid Lobectomy ◽  
Laryngeal Nerve Injury

In our clinic, near-total thyroidectomy is the principal surgical procedure performed for benign thyroid diseases. We conducted a single-institution study on 176 consecutive patients who underwent near-total thyroidectomy due to various thyroid diseases. We compared the incidence of recurrent laryngeal nerve injury between total and near-total thyroid lobectomy sides in each patient. Our hypothesis was that the incidence of recurrent laryngeal nerve injury after total thyroid lobectomy would be similar to that of near-total thyroid lobectomy when the course of the recurrent laryngeal nerve was identified during surgery. The temporary recurrent laryngeal nerve palsy rates on the total and near-total thyroid lobectomy sides were 3.9 per cent (7 of 176 nerves) and 2.2 per cent (4 of 176 nerves), respectively. The difference was not statistically significant. Permanent recurrent laryngeal nerve palsy did not occur in any of our patients. In conclusion, the incidence of recurrent laryngeal nerve injury in total versus near-total thyroid lobectomy is not different when the course of the recurrent laryngeal nerve is identified during surgery.

scholarly journals Association of Intraoperative Neuromonitoring With Reduced Recurrent Laryngeal Nerve Injury in Patients Undergoing Total Thyroidectomy

2016 ◽  
Vol 142 (10) ◽  
pp. 994 ◽  
Author(s):  
Ioannis Vasileiadis ◽  
Theodore Karatzas ◽  
Georgios Charitoudis ◽  
Efthimios Karakostas ◽  
Sofia Tseleni-Balafouta ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Injury ◽  
Recurrent Laryngeal Nerve Injury ◽  
Intraoperative Neuromonitoring ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Injury

scholarly journals Recurrent Laryngeal Nerve Paralysis and Hypocalcemia in Superior to Inferior Compared to Inferior to Superior Dissection Approaches in Thyroidectomy

2018 ◽  
Vol 33 (2) ◽  
pp. 24-27
Author(s):  
Randel D. Yu
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Injury ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Government Hospital ◽  
Nerve Paralysis ◽  
Significant Difference ◽  
Laryngeal Nerve Injury ◽  
Superior Approach

Objective: To compare the incidence of recurrent laryngeal nerve injury and hypocalcemia in patients who underwent thyroidectomy using a superior-inferior versus an inferior to superior approach in identifying the recurrent laryngeal nerve in a tertiary government hospital between January 2012 to December 2016. Methods Design:           Retrospective Cohort Study Setting:           Tertiary Government Hospital Patients:         Records of two hundred forty-one (241) adult patients who underwent surgery for thyroid diseases in the department of Otorhinolaryngology – Head and Neck Surgery   between January 2012 and December 2016 were evaluated. Records of patients with postoperative hoarseness after total thyroidectomy or lobectomy with isthmusectomy and hypocalcemia after total thyroidectomy were reviewed, and operative techniques analyzed for the approaches to recurrent laryngeal nerve identification. Results:           Records of 119 patients (aged 20-73; median 41-years-old) meeting inclusion and exclusion criteria were analyzed. Of 57 thyroidectomies using a superior-inferior approach, 42 were bilateral, totaling 99; of 62 using an inferior-superior approach, 40 were bilateral, totaling 102. There was a higher incidence of post-operative complications among those who underwent inferior-superior dissection than those who underwent superior-inferior dissection. Chi square test showed the former approach (versus the latter) had 4.86 times the relative risk (RR) of permanent RLN injury (1.9%, 0.0475 to 5.5914, p=.3058), 1.62 times the RR of transient RLN injury (5%, 0.3971 to 6.5889, p=.5021), 1.92 times the RR of permanent hypocalcemia (1.9%, 0.0.1806 to 21.2838, p=.5910), and 2.06 times the RR of transient hypocalcemia (17%, 0.9055 to 4.4333, P=.0738). However, there was no significant difference between the two approaches with regard to hoarseness (independent t test, t value 0.90; p = .367) or hypocalcemia (t=0.428; p= .796). Conclusion:    There is no significant difference in the incidence of recurrent laryngeal nerve injury and hypocalcemia in patients who underwent thyroidectomy using a superior-inferior versus an inferior to superior approach in identifying the recurrent laryngeal nerve. Intraoperatively, surgeons may shift from one approach to the other as needed, and we recommend that they be well versed in both approaches and fully knowledgeable of the various anatomical courses of the recurrent laryngeal nerve and locations of parathyroid gland. Keywords: recurrent laryngeal nerve injuries, thyroid neoplasms, thyroidectomy, vocal cord paralysis, hypoparathyroidism, hypocalcemia

scholarly journals Assessment of recurrent laryngeal nerve injury due to thyroid surgery in gorgan medical centers

2020 ◽  
pp. 103-107
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Injury ◽  
Thyroid Surgery ◽  
Demographic Data ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Statistical Population ◽  
Laryngeal Nerve Injury ◽  
Type Of Surgery

Introduction: Thyroid surgery is one of the most common surgeries performed on the neck. There is a possibility of nerve injury and vocal cord paralysis due to the close anatomical relationship between recurrent laryngeal nerve and thyroid. Considering the importance of this study, it was performed to determine nerve damage during thyroid surgery. Methods: This cross-sectional descriptive study was conducted on patients undergoing thyroidectomy at Gorgan University of Medical Sciences, Golestan Province, Iran, from 2016-2017. After providing a list of patients, their files were obtained. The demographic data relating to the type of surgery, type of pathology, and condition of the larynx after surgery were recorded. The patients were asked for a re-examination (if necessary), and the current condition of their larynx was determined. The collected data were recorded and analyzed in SPSS software (version 16). Results: The statistical population of this study consisted of 195 patients, among which 12.3% were male (24 cases), and 87.7% were female (171 patients). The type of surgery in 65.6% (n=128), 28.7% (n=56), and 5.6% (n=11) cases was thyroidectomy, hemithyroidectomy, and subtotal thyroidectomy, respectively. It was revealed that the most common pathology was papillary carcinoma. In terms of complications, there were two cases of laryngeal nerve injury, which persisted in only one case of unilateral paralysis. The type of surgery in both cases was total thyroidectomy. Conclusions: Although recurrent laryngeal nerve injury is not common, in cases of total thyroidectomy, greater care should be taken to preserve the nerve.

scholarly journals Recurrent laryngeal nerve injury in thyroid surgery: a review

2012 ◽  
Vol 83 (1-2) ◽  
pp. 15-21 ◽  
Author(s):  
Nathan James Hayward ◽  
Simon Grodski ◽  
Meei Yeung ◽  
William R. Johnson ◽  
Jonathan Serpell
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Injury ◽  
Thyroid Surgery ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Laryngeal Nerve Injury
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