Prevention and treatment of recurrent laryngeal nerve injury in thyroid surgery.
OBJECTIVE
To summary the experience for prevention and treatment of recurrent laryngeal nerve (RLN) injury in thyroid surgery.


METHODS
Clinical features of 623 patients who received thyroid surgery from January 2010 to December 2012 were analyzed retrospectively, and the features of RLN injury and intraoperative as well as postoperative treatments were reviewed.


RESULTS
RLN injury occurred in 31 patients (4.98%), in which, unilateral RLN injury occurred in 27 patients and bilateral RLN injuries occurred in 4 patients (temporary injury in 28 patients and permanent injury in 3 patients). 6 patients underwent RLN anastomosis during surgery and exhibited transient hoarseness after surgery. RLN exploration and decompression was given in 1 patient and the patient got normal vocal cord motion 2 months after surgery. 1 patient with bilateral injuries received tracheotomy and CO2 laser resection of arytenoid cartilage and achieved recovery 1 year later.


CONCLUSIONS
In order to prevent RLN injury, the anatomic variations of RLN should be mastered. Routine exposure of RLN can effectively prevent the injury in patients receiving the second or multiple surgeries. Early interventions for RLN injury include mainly early discovery, early exploration and early anastomosis, and the function of RLN in some patients can recover completely. Subsequent treatments mainly focus on the improvement of the voice, expansion of glottis and melioration of dyspnea.
Department of General Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University Chongqing 400042, China.
Yan
Y
Jiang
Department of General Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University Chongqing 400042, China.
Bo
B
Gao
Department of General Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University Chongqing 400042, China.
Xiaohua
X
Zhang
Department of General Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University Chongqing 400042, China.
Jianjie
J
Zhao
Department of General Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University Chongqing 400042, China.
Jinping
J
Chen
Department of General Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University Chongqing 400042, China.
Shu
S
Zhang
Department of General Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University Chongqing 400042, China.
Donglin
D
Luo
Thyroid surgery; prevention; recurrent laryngeal (RLN) injury; treatment