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

Erbil, Yeşim; Barbaros, Umut; İşsever, Halim; Borucu, Ismail; Salmaslıoğlu, Artür; Mete, Özgür; Bozbora, Alp; Özarmağan, Selçuk

doi:10.1111/j.1365-2273.2007.01383.x

Cited by 85 publications

(85 citation statements)

References 23 publications

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“…These findings are supported in several other smaller studies, with reported rates for RLNP in thyroid cancer operations ranging from 2% to 50%. 1,6,7,13,21 Our data confirm increased incidence of temporary and permanent RLNP in cancer versus benign disease surgery. The incidence of permanent and transient RLNP in thyroid cancer surgery was 0.28% and 1.82%, respectively.…”

Section: Cancer Surgerysupporting

confidence: 74%

“…5 Permanent post-operative RLNP occurs in approximately 0.3-3% of cases 2,[6][7][8][9] and transient palsies in 3-8% of cases. 1,2,7,9,10 Rates of RLNP are most accurately described in terms of 'nerves at risk' (NAR) and are dependent on the type of surgery and nature of disease. 11 We analysed our data from the Monash University/Alfred Hospital Endocrine Surgery Unit between January 2007 and October 2011.…”

Section: Introductionmentioning

confidence: 99%

“…Damage to a recurrent laryngeal nerve (RLN) with resultant paralysis of the sole abducting muscle (posterior cricoarytenoid) of the vocal cords can cause symptoms ranging from almost undetectable hoarseness in unilateral lesions to stridor and acute airway obstruction in bilateral damage. [1][2][3] RLNP following thyroid surgery is one of the leading reasons for medico-legal litigation against surgeons. 4 Post-operative RLNP is a rare complication of thyroid surgery in expert hands.…”

Section: Introductionmentioning

confidence: 99%

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Recurrent laryngeal nerve injury in thyroid surgery: a review

Hayward

Grodski

Yeung

et al. 2012

ANZ Journal of Surgery

191

129

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Recurrent laryngeal nerve palsy (RLNP) is an important and potentially catastrophic complication of thyroid surgery. Permanent RLNP occurs in 0.3-3% of cases, with transient palsies in 5-8%. A literature review and analysis of recent data regarding RLNP in thyroid surgery was performed, with particular focus on the identification of high-risk patients, the role of intraoperative identification and dissection of the nerve, and the role of intraoperative neuromonitoring (IONM) and optimal perioperative nerve assessment. In conjunction with the review, data from the Monash University/ Alfred Hospital Endocrine Surgery Unit between January 2007 and October 2011 were retrospectively analysed, including 3736 consecutive nerves at risk (NAR). The current literature and our data confirm that patients undergoing re-operative thyroid surgery and thyroid surgery for malignancies are at increased risk of RLNP. Intraoperative visualization and capsular dissection of the RLN remain the gold standard for intraoperative care during thyroid surgery for reducing RLNP risk. IONM should not be used as the sole mechanism for identifying and preserving the nerve, although it can be used to aid in the identification and dissection of the nerve, and may aid in nerve protection in high-risk cases including cancer surgery and re-operative surgery.

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Section: Cancer Surgerysupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Recurrent laryngeal nerve injury in thyroid surgery: a review

Hayward

Grodski

Yeung

et al. 2012

ANZ Journal of Surgery

191

129

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“…2,40,41 Çalışma-mızdaki iki Basedow Graves olgusundan birinde TT, diğerinde ST uygulandığı, iki olguda da hipoparatiroidi geliştiği görülmüştür.…”

Section: Discussionunclassified

Retrospective Analysis of Thyroidectomy Cases That Became Subjects Due to Unintended Consequences

Erkol¹,

Ertan²,

Gökdoğan³

et al. 2012

Turkiye Klinikleri J Med Sci

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Ö ÖZ ZE ET T A Am ma aç ç: : Çalışmada; dava konusu olan tiroid cerrahi girişimlerinin risk alanının belirlenmesi, başta genel cerrahi uzmanları olmak üzere tüm sağlık çalışanlarına olguların verileri konusunda geri bildirimde bulunulması amaçlandı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : 2006-2009 yıllarında Adli Tıp Kurumu Adli Tıp 3. İhtisas Kurulu'nda tiroid cerrahisine bağlı olarak istenmeyen sonuçlar gelişmiş olgular hakkında düzenlenen bilirkişi raporları retrospektif olarak incelendi. Veriler SPSS 13,0 Paket Programı ile değerlendirildi. B Bu ul lg gu ul la ar r: : Toplam 28 olgunun 23'ü (%82,2) kadın, 5'i (%17,8) erkekti. Ortalama yaş 41,3 bulundu. Olguların 13'ü (%46,5) multinodüler guatr (MNG), 3'ü (%10,7) toksik MNG, 2'si (%7,1) nodüler guatr, 2'si (%7,1) Basedow Graves, 2'si (%7,1) kronik lenfositik tiroidit, 2'si (%7,1) nüks guatr, 1'er (%3,6) olgu ise papiller karsinom, anaplastik karsinom, folliküler adenom nedeniyle ve dosyada belirtilmeyen nedenle opere edilmişti. Yirmi bir (%75,0) olguya subtotal tiroidektomi, 7 (%25,0) olguya total tiroidektomi uygulanmıştı. İstenmeyen sonuç olarak olguların 10'unda hipoparatiroidi, 7'sinde tek taraflı vokal kord paralizisi, 5'inde bilateral vokal kord paralizisi, 3'ünde hematom ve 1'er olguda hematom + bilateral vokal kord paralizisi, trakeostomi kanülü kenarından kanama ve özofagus yaralanması meydana gelmişti. Bilirkişi kararlarında 21 olguda uygulanan tedavinin tıp kurallarına uygun olduğu, 6 olguda tıbbi uygulama hatası bulunduğu, 1 olguda tıbbi uygulama hatası yönünden görüş bildirilemeyeceği ifade edilmişti. S So on nu uç ç: : İstenmeyen sonuç gelişen olguların bilimsel ortamlarda tartışılmasının riskin azaltılmasında faydalı olabileceği düşünülmektedir.A An na ah ht ta ar r K Ke el li im me el le er r: : Tiroidektomi; komplikasyonlar; malpraktis A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of to this study was determine the risk area of surgical interventions of the thyroid that became subjects, and to provide feedback about the data of the cases mainly to general surgeons and all health care providers. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Legal expert reports written by the Third Specialized Board of Council of Forensic Medicine between 2006-2009 about cases that developed unintended consequences due to thyroid surgery were analyzed retrospectively. Data were assessed with SPSS 13.0 package program. R Re es su ul lt ts s: : Of a total of 28 cases, 23 (82.2%) were females and 5 (17.8%) were males. Mean age was 41.3 years. Of the cases, 13 (46.5%) were operated on for multinodular goitre (MNG), 3 (10.7%) for toxic multinodular goitre (MNG), 2 (7.1%) for nodular goitre, 2 (7.1%) for Basedow-Graves, 2 (7.1%) for chronic lymphocytic thyroiditis, 2 (7.1%) for recurrent goitre, 1 (3.6%) for papillary carcinoma, 1 (3.6%) for anaplastic carcinoma, 1 (3.6%) for follicular adenoma and 1 (3.6%) for a reason not stated in the file. Twenty-one (75.0%) cases underwent subtotal thyroidectomy and 7 (25.0%) cases...

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“…Postoperative results from thyroid surgeries are usually related to patient condition, the thyroid disease, surgeon's experience and type of surgery 1,2 . Thus, the percentages of undesirable results in thyroidectomy surgeries may vary considerably, considering baseline disease persistence or recurrence and postoperative complications 3 .…”

Section: Introductionmentioning

confidence: 99%

Fatores que influenciam nas complicações das tireoidectomias

Neto

Tagliarini²,

López³

et al. 2012

Braz. j. otorhinolaryngol.

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T he postoperative outcome of thyroidectomies is related to factors concerning the patient, the thyroid disease, and the surgeon. Objectives:To analyze a clinic's experience with thyroidectomy complications. Study design: historical cross-sectional cohort study. Materials and Methods:We reviewed the charts from 228 patients submitted to thyroidectomy, between 1991 and 2004. Transient, permanent and total complications as well as persistence and recurrence of the basal disease were studied in relation to clinical and laboratory factors.Results: Total complications occurred in 34.65%, transient complications in 18.86% (9.21% had hypocalcemia, 0.44% had vocal cord paralysis), associated with the first postoperative years and pressure complaints, and permanent complications in 17.98% (8.77%: hypoparathyroidism; 1.75%: vocal cord paralysis), associated with malignancy and more radical surgeries. The thyroid disease persisted in 17.98% of the cases, associated with age and recurrence in 10.96%, associated with the first operative years, benign diseases and less radical surgeries. Conclusion:The complications were associated with pressure complaints, shorter complaining period, malignancy and more radical surgeries. The recurrence was associated with the first operative years, non-neoplastic thyroid diseases and less radical surgeries. The persistence of disease was associated with older age. Braz J Otorhinolaryngol. 2012;78(3):63-9. ORIGINAL ARTICLE BJORL

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

Abstract: Extentended thyroidectomy and repeat surgery had a significant effect on the incidence of recurrent laryngeal nerve palsy and postoperative hyperparathyroidism respectively following thyroid surgery.

Cited by 85 publications

References 23 publications

Recurrent laryngeal nerve injury in thyroid surgery: a review

Recurrent laryngeal nerve injury in thyroid surgery: a review

Retrospective Analysis of Thyroidectomy Cases That Became Subjects Due to Unintended Consequences

Fatores que influenciam nas complicações das tireoidectomias

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