title: Routine exposure of recurrent laryngeal nerve in thyroid surgery can prevent nerve injury.
abstract: To determine the value of dissecting the recurrent laryngeal nerve during thyroid surgery with respect to preventing recurrent laryngeal nerve injury, we retrospectively analyzed clinical data from 5 344 patients undergoing thyroidectomy. Among these cases, 548 underwent dissection of the recurrent laryngeal nerve, while 4 796 did not. There were 12 cases of recurrent laryngeal nerve injury following recurrent laryngeal nerve dissection (injury rate of 2.2%) and 512 cases of recurrent laryngeal nerve injury in those not undergoing nerve dissection (injury rate of 10.7%). This difference remained statistically significant between the two groups in terms of type of thyroid disease, type of surgery, and number of surgeries. Among the 548 cases undergoing recurrent laryngeal nerve dissection, 128 developed anatomical variations of the recurrent laryngeal nerve (incidence rate of 23.4%), but no recurrent laryngeal nerve injury was found. In addition, the incidence of recurrent laryngeal nerve injury was significantly lower in patients with the inferior parathyroid gland and middle thyroid veins used as landmarks for locating the recurrent laryngeal nerve compared with those with the entry of the recurrent laryngeal nerve into the larynx as a landmark. These findings indicate that anatomical variations of the recurrent laryngeal nerve are common, and that dissecting the recurrent laryngeal nerve during thyroid surgery is an effective means of preventing nerve injury.
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Ear Institute, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Chenling
authors.initials: C
authors.lastname: Shen
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Ear Institute, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Mingliang
authors.initials: M
authors.lastname: Xiang
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Ear Institute, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Ear Institute, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Ear Institute, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Li
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Ear Institute, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Cheng
keywords: dissection; grants-supported paper; inferior parathyroid gland; middle thyroid vein; nerve anatomy; nerve injury; neural regeneration; neuroregeneration; peripheral nerve injury; recurrent laryngeal nerve; thyroid diseases; thyroidectomy; variations