Recurrent laryngeal nerve palsy after thyroid surgery.
The identification of the risk factors associated with the increased incidence of the nerve injury is of paramount importance. Twenty-nine of 581 patients who developed recurrent laryngeal nerve palsy after thyroidectomy were analyzed retrospectively. There were 23 women (79%) and 6 men (21%), with a mean age of 45.6 years (range, 22-66 years). Eleven patients had right vocal cord paralysis, 8 had left vocal cord paralysis, and 10 patients had bilateral involvement. Ten patients underwent near total thyroidectomy (34.4%), eight patients underwent bilateral subtotal thyroidectomy (27.5%), six patients underwent total thyroidectomy (20.7%), and five patients underwent unilateral lobectomy (17.2%). Four of 10 patients with bilateral vocal cord paralysis had a unilateral nerve injury detected with laryngoscopy before surgery. Only five patients developed permanent vocal cord paralysis (17%). Three patients with permanent paralysis underwent reoperative thyroid surgery and had a total lobectomy. One patient required a tracheostomy, and arytenoidectomy was performed in one patient at a later follow-up period. Most recurrent laryngeal nerve palsy after thyroidectomy was transient. Permanent paralysis is associated with reoperative thyroid surgery.
Alimoglu
Orhan
O
First Department of Surgery, Vakif Gureba Training Hospital, Istanbul, Turkey. oalimoglu@yahoo.com
Akdag
Murat
M
Kaya
Bulent
B
Eryilmaz
Ramazan
R
Okan
Ismail
I
Coskun
Aytekin
A
Sahin
Mustafa
M
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000009:adverse effects*; D014826:Vocal Cord Paralysis / Q000209:etiology*; D055815:Young Adult