Factors And Incidence Of Recurrent Laryngeal Injury During Thyroid Surgery In A Surgical Unit Of A Tertiary Care Hospital., Indo Am (original) (raw)
Related papers
Recurrent laryngeal nerve injury in thyroid surgery
Oman medical journal, 2011
Vocal cord paresis or paralysis due to iatrogenic injury of the recurrent laryngeal nerve (RLNI) is one of the main problems in thyroid surgery. Although many procedures have been introduced to prevent the nerve injury, still the incidence of recurrent laryngeal nerve palsy varies between 1.5-14%. The aim of the present study is to assess the risk factors of recurrent laryngeal nerve injury during thyroid surgery. Patients who had thyroid surgery between 1990 and 2005 and were admitted to the surgical department of King Fahd hospital of the University, Al-Khobar, Saudi Arabia were enrolled for this retrospective review, Factors predisposing to recurrent laryngeal nerve injury were evaluated such as pathology of the lesions and the type of operations and identification of recurrent laryngeal nerve intra-operatively. Preoperative and postoperative indirect laryngoscopic examinations were performed for all patients. 340 patients were included in this study. Transient unilateral vocal c...
Recurrent laryngeal nerve injury (RLNI) in thyroid surgery and its prevention
International Journal of Research in Medical Sciences, 2015
Background: Vocal cord paresis or paralysis due to iatrogenic injury of the recurrent laryngeal nerve (RLNI) is one of the main problems in thyroid surgery. Although many procedures have been introduced to prevent the nerve injury, still the incidence of recurrent laryngeal nerve palsy varies between 1.5-14%. The aim of the present study is to assess the risk factors of recurrent laryngeal nerve injury during thyroid surgery. Methods: This was a prospective, observational study conducted in the
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.
The Internet Journal of Surgery
Background: Recurrent laryngeal nerve paralysis is one of the most frequent and serious complications after thyroid operation. Routine dissection and demonstration of the recurrent nerve remain controversial. To know the risk of damage of the recurrent laryngeal nerve, a prospective study was done randomly in 50 patients.Material and method: Fifty consecutive patients underwent thyroidectomy. Only patients with normal vocal cords were included in the study. Patients were allocated to two groups randomly, in group (a) the nerve was not identified and in group (b) the nerve was identified.Results: There were 29 unilateral and 21 bilateral operations performed, with 71 nerves at risk. Out of these 50 operations, 4 patients in the group without nerve identification developed nerve palsy (16%) but the percentage of nerves injured was 2.84%.Conclusions: Careful dissection of the nerve during surgery essentially eliminates the risk of nerve injury during surgery.
Assessment of recurrent laryngeal nerve function during thyroid surgery
Annals of the Royal College of Surgeons of England, 2014
There is disparity in the reported incidence of temporary and permanent recurrent laryngeal nerve (RLN) palsy following thyroidectomy. Much of the disparity is due to the method of assessing vocal cord function. We sought to identify the incidence and natural history of temporary and permanent vocal cord palsy following thyroid surgery. The authors wanted to establish whether intraoperative nerve monitoring and stimulation aids in prognosis when managing vocal cord palsy. Prospective data on consecutive thyroid operations were collected. Intraoperative nerve monitoring and stimulation, using an endotracheal tube mounted device, was performed in all cases. Endoscopic examination of the larynx was performed on the first postoperative day and at three weeks. Data on 102 patients and 123 nerves were collated. Temporary and permanent RLN palsy rates were 6.1% and 1.7%. Most RLN palsies were identified on the first postoperative day with all recognised at the three-week review. No preoper...
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.
Recurrent and superior laryngeal nerve injury in thyroid surgery: literature review
International Journal Of Community Medicine And Public Health
Laryngeal nerve injury is considered one of the most common complications after thyroidectomy. It is associated with decreased quality of life because it will result in hoarseness of voice and aspiration. Identification of the risk factors and procedures to decrease the injury is crucial for handling laryngeal nerve injury. We searched the MEDLINE database using PubMed. Two independent reviewers reviewed the resulting papers and reviewed them based on our inclusion criteria. Based on the review results, the incidence of recurrent laryngeal nerve injury is higher than the external branch of the superior laryngeal nerve, but it is mainly due to under-reporting of the external branch of superior laryngeal nerve injury. Cancer surgery, surgeon experience, workload, re-operative procedures, and extent of surgery increased the incidence of the laryngeal nerve injury. Handling of these risk factors combined with visual dissection and inspection and/or intraoperative nerve monitoring decrea...
[Recurrent laryngeal nerve injury after thyroidectomy and preoperative nerve monitoring]
Annales françaises d'anesthèsie et de rèanimation, 2006
Recurrent laryngeal nerve (RLN) injury is a feared complication after thyroid and parathyroid surgery. It induces important postoperative morbidity. The present study aimed to assess the incidence of transient/permanent postoperative RLN injuries after thyroid and parathyroid surgery in the present cohort, to observe the timing of recovery, and to identify risk factors for permanent RLN injury after thyroidectomy. All consecutive patients operated on at our institution for thyroid and parathyroid pathologies from 2005 to 2013 were reviewed for vocal cord paresis. Vocal cord paresis was defined based on postoperative fiberoptic laryngoscopy. Demographics, intraoperative details, and postoperative outcomes were collected. Treatment types were assessed, and recovery times collected. Patients with vocal cord paresis on preoperative fiberoptic laryngoscopy were excluded from the analysis. The cohort included 451 thyroidectomies (756 nerves at risk) and 197 parathyroidectomies (276 nerves at risk). There were 63 postoperative vocal cord pareses after thyroidectomy and 13 after parathyroidectomy. Sixty-nine were transient (10.6%) and 7 permanent (1.1%). The main performed treatment was speech therapy in 51% (39/76) of the patients. Median recovery time after transient injuries was 8 weeks. In the group with vocal cord paresis, risk factors for permanent injuries after thyroidectomy were previous thyroidectomy and intraoperative RLN injury on univariate analysis. On multivariate analysis, only intraoperative RLN injury remained significant. Most of the patients with transient postoperative RLN injury recovered normal vocal cord mobility within 6 months. The most common performed treatment was in this cohort speech therapy. Permanent RLN injuries remained rare (1.1%).
Recurrent Laryngeal Nerves Injury During Thyroid Surgery
Journal of Surgical Arts, 2014
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 to prevent its damage. To evaluate our routine identification of the recurrent laryngeal nerves (RLNs) during thyroidectomy aiming lessen the inadvertent injury of the RLN during surgery. A convenience sample, non probability total coverage multicentre Hospital based descriptive prospective study (December 2009 to May 2012) included all patients managed by subtotal thyroidectomy after acceptance the informed consent. All operations were undertaken in both hospitals by the same surgical team. Data collected using a predesigned questionnaire. All thyroidectomies were evaluated, and the various types of recurrent laryngeal nerves were recorded. Data was analyzed using SPSS version 15.0. It included 82 patients [69 (84.15%) females and 13 (15.85%) males], with male to female ratio of 1:5.3. Their mean age was 42.8 years (SD±8.4 years). All were treated by subtotal thyroidectomy. The rate of identification of the RLN was 100% for all patients. The overall frequency of RLN injury was 1.2% seen in one patient. Study proved that surgical exposure of the RLNs avoids the incidence of its damage.