The efficacy of intraoperative corticosteroids in recurrent laryngeal nerve palsy after thyroid surgery.
BACKGROUND
Recurrent laryngeal nerve palsy (RLNP) is one of the most common complications after thyroidectomy. We aim to evaluate the role of intraoperative corticosteroids in preventing or treating postoperative RLNP.


METHODS
We conducted a prospective study of 295 patients who underwent either total lobectomy or total thyroidectomy with or without using intraoperative corticosteroids. All cases were operated on by the same surgeon. Measurement of the RLNP rate was based on the number of nerves at risk. Data were analyzed for differences in postoperative temporary or permanent RLNP rate and recovery days.


RESULTS
The rate of temporary/permanent RLNP was 5.7% (11 out of 194)/0.52% (1 out of 194) and 6.9% (12 out of 173)/0.58% (1 out of 173) according to groups with and without corticosteroids. This difference did not reach statistical significance. Among those 23 patients who recovered from RLNP, the mean time to recovery was significantly shorter for patients receiving intraoperative steroids (28.6 vs. 40.5 days, P = 0.045).


CONCLUSIONS
A single dose of intraoperative corticosteroids did not produce any benefit in terms of reducing the postoperative temporary/permanent RLNP rate, but it did shorten the recovery time for patients suffering from temporary RLNP.
Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung 807, Taiwan.
Ling-Feng
LF
Wang
Ka-Wo
KW
Lee
Wen-Rei
WR
Kuo
Che-Wei
CW
Wu
Shang-Pin
SP
Lu
Feng-Yu
FY
Chiang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D061226:Recurrent Laryngeal Nerve Injuries; D018709:Statistics, Nonparametric; D013965:Thyroidectomy / Q000009:adverse effects*; D014826:Vocal Cord Paralysis / Q000209:etiology* / Q000517:prevention & control*
D000893:Anti-Inflammatory Agents; D006854:Hydrocortisone