Immediate Recurrent Laryngeal Nerve Repair During Thyroidectomy

Document Type : Original Article

Authors

1 Maxillofacial,head and neck surgery ,egypt- sohag- faculty of medicine - surgery department

2 general surgery department faculty of medicine sohag university

3 * Otolaryngology - Head and Neck Surgery Department, Sohag University, Sohag, Egypt.

Abstract

Background: One of the most frequent problems after thyroidectomies is an injury to the recurrent laryngeal nerve (RLN) that will lead to vocal cord palsy. This study aimed to assessed the outcomes of intraoperative repair of the recurrent laryngeal nerve.
Patients and Methods: In the period of the study we retrived the data of patients who had been underwent thyroid surgery and they sufferd from RLN injery or scarification with immediate intraoperative nerve repair. This retrospective study has been conducted between 2012 and 2020, 813 patients underwent thyroid surgery, 27 (3.3%) of them diagnosed with RLN injury and divided into 2 groups: group A (n = 9), with intraoperative proof of iatrogenic injury of the RLN, and group B (n = 18), in which malignant invasion was diagnosed intraoperative or recognized during thyroidectomy with a therapeutic transection. Immediate microsurgical reconstruction of the RLN was performed. The evaluation was performed at 3, 6, and 9 months post-surgical repair utilizing aspiration and voice improvement as subjective tests, fiberoptic direct laryngoscopy as an objective test.
Results: Aspiration significantly improved in both groups (p < 0.05). Voice quality improved in both groups but better in group A (p = 0.02).
Conclusion: Immediate RLN reconstruction during thyroidectomies gave excellent postoperative voice quality especially after thyroidectomies in benign thyroid lesions.

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