title: Risk factors for recurrent nerve palsy after thyroid surgery: a national study of patients treated at Danish departments of ENT Head and Neck Surgery.
abstract: Recurrent laryngeal nerve (RLN) injury is a well-known and serious complication to thyroid surgery. The objective was to estimate the frequency of post-thyroidectomy RLN palsy and to identify possible risk factors. Based on the Danish national thyroid surgery database, 6,859 patients treated with thyroid surgery from 1 January 2001 to the 31 December 2008 at the Danish departments of ENT-HNS were analyzed. Unilateral RLN palsy was found in 2.1 % and bilateral in 0.1 %. In benign histology, RLN palsies were registered in 1.3 %. Malignant histology and accordingly neck dissection were the most predominant risk factors with a relative risk (RR) of 5.4 and 5.8, respectively. In benign cases previous performed thyroid surgery had a RR of 10.4. High volume departments with more than 150 thyroid procedures per year seem to perform significantly better. Malignant histology, neck dissection and previous performed thyroid surgery are the strongest predictors for RLN palsy and patient information should be given accordingly. Incomplete resections should be reserved for isthmectomy only. Centralization of thyroid surgery in larger units might improve quality.
authors.affiliation: Department of ENT Head and Neck Surgery, Odense University Hospital, 5000, Odense C, Denmark, christian.godballe@rsyd.dk.
authors.forename: Christian
authors.initials: C
authors.lastname: Godballe
authors.forename: Anders Rørbæk
authors.initials: AR
authors.lastname: Madsen
authors.forename: Christian Hjort
authors.initials: CH
authors.lastname: Sørensen
authors.forename: Sten
authors.initials: S
authors.lastname: Schytte
authors.forename: Waldemar
authors.initials: W
authors.lastname: Trolle
authors.forename: Jens
authors.initials: J
authors.lastname: Helweg-Larsen
authors.forename: Lisa
authors.initials: L
authors.lastname: Barfoed
authors.forename: Larry
authors.initials: L
authors.lastname: Kristiansen
authors.forename: Vibeke Zederkof
authors.initials: VZ
authors.lastname: Sørensen
authors.forename: Grethe
authors.initials: G
authors.lastname: Samuelsen
authors.forename: Henrik Baymler
authors.initials: HB
authors.lastname: Pedersen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D061226:Recurrent Laryngeal Nerve Injuries / Q000150:complications / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D014826:Vocal Cord Paralysis / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult