Identification of the nonrecurrent laryngeal nerve during thyroid surgery: 20-year experience.
The nonrecurrent laryngeal nerve, which is rarely observed during thyroidectomy, is at high risk for damage. During a 20-year period 6000 thyroidectomies were performed at our institution, and during these operations inferior laryngeal nerves were routinely identified in all the patients with a standard procedure based on the usual anatomic landmarks. A nonrecurrent laryngeal nerve was observed on the right side in 31 cases (0.51%), with no anatomic anomalies found on the left side. The nerve anomaly was diagnosed preoperatively in five patients. A vocal cord deficit, caused by a nerve lesion, was observed in four cases (12.9%). Our results suggest that the best way to avoid morbidity is routine identification of the nerve. This can be done by carefully identifying all the thyroid structures and being suspicious of the presence of the abnormality when the inferior laryngeal nerve is not found in a classic position.
Toniato
Antonio
A
Surgical Pathology, Department of Medical and Surgical Sciences, Policlinico Universitario, University of Padua, School of Medicine, Via Giustiniani 2, Padua 35128, Italy. giorgiolina@libero.it
Mazzarotto
Renzo
R
Piotto
Andrea
A
Bernante
Paolo
P
Pagetta
Costantino
C
Pelizzo
Maria Rosa
MR
D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D012009:Recurrent Laryngeal Nerve / Q000002:abnormalities*; D061226:Recurrent Laryngeal Nerve Injuries; D013965:Thyroidectomy / Q000009:adverse effects