Recurrent laryngeal nerve injury in thyroid surgery: Clinical pathways and resources consumption.
The impact of recurrent laryngeal nerve (RLN) injury management in thyroid surgery seems to be relevant to patients, National Healthcare System (NHS), and society.



We studied resource consumption in the management of patients with RLN injury versus noninjured patients investigating 3 perspectives (patients, NHS, and society) in 5 clinical pathways.



Direct medical costs supported by the NHS range from a minimum of euro (€) 79.46 to a maximum of € 3261.95. From the patient's perspective, the direct medical costs supported by the patient increased from a minimum of € 3.60 to a maximum of € 499.45. Productivity losses were accounted in € 156 per day per patient. From the NHS perspective, the percentage increase ranged from 43.25% to 98.14%. From the patient's perspective, it ranged from 51.52% to 80.60%.



The analysis shows a significant economic impact of RLN injury management, which varies depending on the damage, duration, and severity. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016.
Endocrine Surgery Research Center, Department of Surgical and Morphological Sciences, University of Insubria (Varese-Como), Varese, Italy.
Cesare Carlo
CC
Ferrari
Department of Surgical and Morphological Sciences, University of Insubria (Varese-Como), Varese, Italy.
Stefano
S
Rausei
Department of Surgical and Morphological Sciences, University of Insubria (Varese-Como), Varese, Italy.
Francesco
F
Amico
Minimally Invasive Surgery Research Center, Department of Surgical and Morphological Sciences, University of Insubria (Varese-Como), Varese, Italy.
Luigi
L
Boni
Department of Otolaryngology - Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Feng-Yu
FY
Chiang
Department of Otolaryngology - Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Che-Wei
0000-0003-1052-5348
CW
Wu
Department of Surgery, KUMC Thyroid Center, Korea University Hospital, Korea University College of Medicine, Seoul, Korea.
Hoon Yub
HY
Kim
Department of Surgical and Morphological Sciences, University of Insubria (Varese-Como), Varese, Italy. gianlorenzo.dionigi@uninsubria.it.
Gianlorenzo
G
Dionigi
D019091:Critical Pathways; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007431:Intraoperative Complications / Q000191:economics*; D007558:Italy; D061226:Recurrent Laryngeal Nerve Injuries / Q000191:economics*; D013222:State Medicine / Q000191:economics*; D013961:Thyroid Gland / Q000601:surgery*; D014826:Vocal Cord Paralysis / Q000191:economics
cost analysis; recurrent laryngeal nerve (RLN) injury; thyroid surgery; vocal fold palsy; voice damage