Study of Complications of Thyroidectomy with Special Reference to Recurrent Laryngeal Nerve Injury

Abstract

Background: Thyroidectomy is one of the most commonly performed procedure for thyroid disorders. The mortality and mobidity of thyroidectomy was very high. Sterile surgical arenas, advent of anaesthesia, and improved surgical techniques have reduced it considerably. Patients must be appropriately counseled in the preoperative period regarding the potential complications. They must be well aware of the surgical risks they are to undertake. A thorough understanding of anatomy and with experience, the surgeon can minimise the risk associated with the procedure. Aim: Study the incidence of complications of thyroidectomy with special reference to recurrent laryngeal nerve injury. Methods: This is a hospital based prospective study, from 2008 to 2015.823 cases who underwent thyroidectomy for any indications at a tertiary care institution at north Malabar .Data collection: A detailed clinical evaluation was done. Intra operative documentation of surgical details was done. Post operatively the patients were monitored for any complications. Follow up serum TSH was monitored in second post op week, and then every month till six months. Results: The overall incidence of complications is 35.76%. Commonest complication is transient hypoparathyroidism(21.87%), followed by transient RLN injury (3.4%), permanent hyoparathyroidism (3.2%), flap edema (2.3%), EBSLN injury (2.06%), hematoma (1.45%), hypothyroidism (0.97%) and wound infection (0.73%). Conclusion: Meticulous dissection, absolute hemostasis, and a thorough knowledge of neck anatomy are the key in reducing the post thyroidectomy complications. Identification and preservation of the laryngeal nerves and parathyroids are mandatory. Incidences of other complications are on the decline.