title: Recurrent laryngeal nerve paralysis: a complication of thyroidectomy.
abstract: OBJECTIVE
  To study factors related to recurrent laryngeal nerve (RLN) paralysis, a major complication of thyroidectomy.
  
  
  METHODS
  Retrospective study of outcome of patients' medical records.
  
  
  METHODS
  Records of 361 patients who underwent thyroidectomy by otolaryngologists at Ramathibodi Hospital were reviewed for RLN paralysis.
  
  
  METHODS
  RLN injury was analyzed in relation to types of surgery, RLN identification, and histopathology. The analysis was based on the number of RLNs at risk.
  
  
  RESULTS
  The incidence of permanent RLN paralysis was 2.38%. Both the permanent RLN paralysis and temporary RLN paralysis were significantly related to the histopathologic findings of malignancy (p < .005). The positive identification of RLN and the types of surgery were not found to be significant factors in either permanent RLN paralysis or temporary RLN paralysis.
  
  
  CONCLUSIONS
  There was insufficient evidence to support that the identification of RLNs during surgery would be a significant factor in reducing the likelihood of RLN paralysis. However, RLNs should be identified to avoid iatrogenic injury and subsequent paralysis. Meticulous surgical technique should be applied in patients whose results of fine-needle aspiration biopsy suggested malignancy, as there is the possibility of difficult surgery and potential iatrogenic RLN paralysis in this group of thyroid patients.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: L
authors.initials: L
authors.lastname: Kasemsuwan
authors.forename: S
authors.initials: S
authors.lastname: Nubthuenetr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D061226:Recurrent Laryngeal Nerve Injuries; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects*; D014826:Vocal Cord Paralysis / Q000209:etiology* / Q000517:prevention & control