Morbidity of prophylactic lymph node dissection in the central neck area in patients with papillary thyroid carcinoma (original) (raw)
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Hypoparathyroidism in Total Thyroidectomy due to Benign Thyroid Diseases
Clinical therapeutics, 2018
Our aim was to compare the effects of exposing the recurrent laryngeal nerve throughout its entire course with exposing the nerve only at its entry to the larynx in patients undergoing total thyroidectomy due to benign thyroid diseases, and to evaluate the effects of these methods on the risk for hypoparathyroidism. The medical records of 437 patients who had undergone total thyroidectomy at the ear, nose, and throat clinic between 2001 and 2015 for benign thyroid diseases were evaluated retrospectively. Mean patient age was 46.7 years (range 18-79 years). Eighty-six patients were male and 351 were female. Patients were divided into 2 groups according to recurrent laryngeal nerve exposure during surgery. In the first group, the nerve was observed as it entered the larynx, and its course was not completely exposed. In the second group, the nerve was identified in the tracheoesophageal groove, and its course was fully exposed. Group 1 consisted of 256 patients (47 male and 209 female)...
Recurrent Laryngeal Nerve Injury In Total Versus Subtotal Thyroidectomy
Journal of Ayub Medical College, Abbottabad : JAMC
Both Total and Subtotal Thyroidectomy are correct treatment options for symptomatic Euthyroid Multinodular Goitre. The choice depends upon surgeon's preference due to consideration of disadvantages like permanent hypothyroidism in Total Thyroidectomy and high chances of recurrence in Subtotal Thyroidectomy. Many surgeons believe that there is a higher incidence of Recurrent Laryngeal nerve injury in Total Thyroidectomy which affects their choice of surgery. This study aimed to compare the incidence of recurrent laryngeal nerve injury in total versus subtotal thyroidectomy. This non randomized controlled trial was carried out at Department of Surgery and ENT of Ayub Teaching Hospital Abbottabad, and Combined Military Hospital Rawalpindi from 1st September 2013 to 30th August 2014. During the period of study, patients presenting in surgical outpatient department with euthyroid multinodular goitre having pressure symptoms requiring thyroidectomy were divided into two groups by conv...
Risk factors for recurrent laryngeal nerve palsy after thyroidectomy
Central European Journal of Medicine, 2011
This study investigates the incidence of temporary and permanent recurrent laryngeal nerve palsy (RLNP) and possible risk factors for patients with different types of thyroid gland diseases. 1224 consecutive patients who underwent thyroidectomy for treatment of various thyroid diseases between the years 2001–2005. The rates of RLNP were evaluated. The surgeon and type of thyroid gland disorder were recognised as possible risk factors for RLNP. The incidence of temporary/permanent RLNP for the whole group was 4.5/0.8%. The rates of temporary RLNP for groups, classified as multinodular goitre, Graves’ disease, thyroid cancer or Hashimoto’s disease were 4.3%, 4.3%, 5.2% and 5.7%, respectively. The rates of permanent RLNP for the same groups were 0.4%, 0.9%, 1.6% and 1.9%, respectively. The frequency of temporary RLNP for individual surgeons ranges from 2.8 to 7.0% and the rates of permanent RLNP is between 0–3.1%. There was no relationship between the surgeon’s experience (the number of procedures performed) and RLNP rates. Total thyroidectomy is a safe procedure associated with a low incidence of RLNP not only for benign multinodular goitre, but also for Graves’disease, thyroid cancer and Hashimoto’s disease. The rates of RLNP among individual surgeons are acceptable with small inter-individual differences.
Total thyroidectomy is safer with identification of recurrent laryngeal nerve
Journal of Zhejiang University-science B, 2008
Objective To investigate the effect of recurrent laryngeal nerve (RLN) identification on the complications after total thyroidectomy and lobectomy. Methods Total 134 consecutive patients undergoing total thyroidectomy or thyroid lobectomy from January 2003 to November 2004 were investigated retrospectively. Patients were divided into two groups: RLN identified (Group A) or not (Group B). The two groups were compared for RLN injury and hypocalcaemia. Results The numbers of patients and nerves at risk were 71 and 129 in Group A, and 63 and 121 in Group B, respectively. RLN injury in Group A (0) was significantly lower than that in Group B (5 [7.9%]) patients, 7 [5.8%] nerves) for the numbers of patients (P=0.016) and nerves at risk (P=0.006). Temporary hypocalcaemia was significantly higher in Group A than in Group B (14 [24.1%] vs 6 [10.3%], P=0.049). Permanent complications in Group B were significantly higher than those in Group A (13 [20.6%] vs 4 [5.6%], P=0.009). Conclusion RLN injury was prevented and permanent complications were decreased by identifying the whole course and branches of the recurrent laryngeal nerve during total thyroidectomy.
PubMed, 2015
This prospective, cross sectional study was carried out in the Department of Otolaryngology & Head-Neck Surgery, Mymensingh Medical College Hospital, Bangladesh from August 2010 to July 2011. One hundred & twenty eight (128) patients with thyroid swelling who underwent surgery were purposely included. The study was designed to determine the incidence of recurrent laryngeal nerve injury during thyroid surgery. Among the 128 patients, female were predominant 78.90%, majority of the patient were in third decade, 96.87% patients were biochemically euthyroid. Total 5.46% patient had recurrent laryngeal nerve injury. Among them 14.28% had transient and 85.72% had permanent injury. Injury was more in total thyroidectomy done for extensive malignancy.
Incidence of Recurrent Laryngeal Nerves Injury during Thyroid Surgery
Abstract: The technique of thyroidectomy has been in evolution for many years. It is a fundamental principle of surgery that a structure must be identified clearly during the procedure in order to prevent its damage. The objective of the study was to evaluate our routine identification of the recurrent laryngeal nerves during thyroidectomy aiming lessen the inadvertent injury of the recurrent laryngeal nerves during surgery. The study includes a convenience sample, non probability total coverage multicentre hospital based descriptive prospective study (December 2009 to May 2012) including all adult patients managed by subtotal thyroidectomy after acceptance of the pre given informed consent. All operations were undertaken by the same surgical team. Data collected using a predesigned questionnaire. Data analysis was performed using SPSS version 15.0 for Windows. The study included 82 patients (69 (84.15%) females and 13(15.85%) males), with male to female ratio of 1:5.3. Their mean a...
Bengal Journal of Otolaryngology and Head Neck Surgery
Introduction: Recurrent laryngeal nerves (RLN) are particularly prone to injury during thyroid surgeries due to its intimate relationship and proximity with the gland. Zuckerkandl’s tubercle (ZT) helps in preserving RLN intra operative. Material and Methods: A prospective study for identifying RLN in thyroid surgery using relationship with superior parathyroid gland and tubercle of Zuckerkandl was conducted on 50 thyroidectomy patients between August 2013 and February 2014. Results: In all cases ZT was identified. Temporary paralysis of RLN was seen in 3 (6%) cases and permanent paralysis in 2 (4%) of cases. Discussion: The site of greatest risk during thyroidectomy to the RLN is in the last 2-3 cm extralaryngeal course of the nerve. Relationship of recurrent laryngeal nerve with superior parathyroid gland and tubercle of Zukerkandl (ZT) is known. Conclusion: Use of ZT and superior parathyroids as a landmark allows safe dissection of RLN.
2015
Introduction Recurrent laryngeal nerves (RLN) are particularly prone to injury during thyroid surgeries due to its intimate relationship and proximity with the gland. Zuckerkandl's tubercle (ZT) helps in preserving RLN intra operative. Materials and Methods A prospective study for identifying RLN in thyroid surgery using relationship with superior parathyroid gland and tubercle of Zuckerkandl was conducted on 50 thyroidectomy patients between August 2013 and February 2014. Results In all cases ZT was identified. Temporary paralysis of RLN was seen in 3 (6%) cases and permanent paralysis in 2 (4%) of cases. Discussion The site of greatest risk during thyroidectomy to the RLN is in the last 2-3 cm extralaryngeal course of the nerve. Relationship of recurrent laryngeal nerve with superior parathyroid gland and tubercle of Zukerkandl (ZT) is known. Conclusion Use of ZT and superior parathyroids as a landmark allows safe dissection of RLN.