RECURRENT LARYNGEAL NERVE INJURY: AN EXPERIENCE WITH 310 THYROIDECTOMIES

Ishtiaq Ahmed Chaudhary, Sami ullah, Rehan Masood, Muhammad Ashraf Majrooh, Ashraf Ali Mallhi

Abstract


Background: Thyroid surgery has been associated with complications ranging from nerve injury
to death. Improvements in techniques have reduced the mortality rate to minimum. Morbidity,
however, remains a significant concern. This study was designed to determine the prevalence of
recurrent laryngeal nerve (RLN) injury and duration of recovery following transient recurrent
laryngeal nerve injury, during thyroid surgery. Methods: This prospective, observational study
was carried out in the Surgical Department of Fauji Foundation Hospital, Rawalpindi, from
January 2000 to December 2005. All patients undergoing Thyroid surgery were included.
Results: 310 patients, predominantly female (97.09%), were operated. Majority were euthyroid
(90.33%). 3.22% patients had recurrent laryngeal nerve injury. Amongst them, 87.5% had
transient and 12.5% had permanent nerve lesion. Majority of the patients (87.5%) showed signs of
recovery within 12 weeks after surgery. Injury was observed more in huge goiters (3.57% transient
and 1.42% permanent), total thyroidectomy (7.69% transient and 3.84% permanent) and during
lobectomy and total thyroidectomy (6.25% respectively for transient and permanent nerve injury.
Conclusion: Thyroid surgery should be done by experienced surgeon and care should be taken
especially in huge goiters and patients undergoing total thyroidectomy.
Keywords: Thyroidectomy; Recurrent laryngeal nerve; Injury; Prevalence; Recovery

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