Risk factors for recurrent laryngeal nerve palsy after thyroidectomy

Abstract

<jats:title>Abstract</jats:title><jats:p>This study investigates the incidence of temporary and permanent recurrent laryngeal nerve palsy (RLNP) and possible risk factors for patients with different types of thyroid gland diseases. 1224 consecutive patients who underwent thyroidectomy for treatment of various thyroid diseases between the years 2001–2005. The rates of RLNP were evaluated. The surgeon and type of thyroid gland disorder were recognised as possible risk factors for RLNP. The incidence of temporary/permanent RLNP for the whole group was 4.5/0.8%. The rates of temporary RLNP for groups, classified as multinodular goitre, Graves’ disease, thyroid cancer or Hashimoto’s disease were 4.3%, 4.3%, 5.2% and 5.7%, respectively. The rates of permanent RLNP for the same groups were 0.4%, 0.9%, 1.6% and 1.9%, respectively. The frequency of temporary RLNP for individual surgeons ranges from 2.8 to 7.0% and the rates of permanent RLNP is between 0–3.1%. There was no relationship between the surgeon’s experience (the number of procedures performed) and RLNP rates. Total thyroidectomy is a safe procedure associated with a low incidence of RLNP not only for benign multinodular goitre, but also for Graves’disease, thyroid cancer and Hashimoto’s disease. The rates of RLNP among individual surgeons are acceptable with small inter-individual differences.</jats:p>

Unintentional recurrent laryngeal nerve injuries following thyroidectomy: Is it the surgeon who pays the bill?

“…"Nerves at risk" (NAR) should be considered as additional conditions e patient, thyroid pathology or surgery related -increasing the chances of a neural damage [18]. Re-intervention is one of the most important predisposing factor for NAR.…”

Recurrent laryngeal nerve injury in thyroid surgery: a review

“…1,11,13 Intraoperative visualization and dissection of the RLN In the early 1900s, Lahey of Boston (1938) and Riddell of London (1956) revolutionized thyroid surgery by advocating routine identification and dissection of the RLN. 35 This method was not initially endorsed, with early studies disputing the effect of routine identification in protecting the RLN.…”

“…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. A total of 2422 thyroid resection procedures were included, with a total of 3736 NAR (Table 1).…”

Bipolar Thermofusion BiClamp 150 in Thyroidectomy: A Review of 1156 Operations

“…In this area only conventional bipolar coagulation was used in BiClamp group. The incidence of RLN paresis in the literature is 0.8–2.5% of all lobes operated, with higher rates occurring in older patients [ 1 , 12 – 14 ]. Our findings are in agreement with these.…”