RECURRENT LARYNGEAL NERVE PALSY AFTER THYROID SURGERY AND LITERATURE REVIEW

Abstract

Objective:

To  observe the recurrent laryngeal nerve (RLN) status after thyroid surgery done for various types of thyroid pathology.

Material and Methods:

It was a prospective observational study done from 1st of November 2006 to 31st of October  2010 in Ganesh Man Singh Memorial Acadamy of ENT & HN Studies, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgung, Kathmandu. Patients undergoing different types of thyroid surgeries for both malignant and non malignant thyroid pathology were included in the study. The status of recurrent laryngeal nerve during surgery and early postoperative period were observed.

Results:

There were total 112 cases of thyroid surgery  done over a period of four year. Recurrent laryngeal nerve ( RLN) palsy was observed in 15 cases in immediate postoperative period . Out of which, 10 cases fully recovered within 3 weeks of surgery and 5 cases didn’t show any recovery. In 2 cases, recurrent  laryngeal nerve was sacrificed because it was involved by the thyoid malignancy. The nerve was not identified in 5 cases because it was involved by the disease in 2 cases and in remaining 3 cases anatomy was distorted due to large size of thyroid mass.

Conclusion:

RLN palsy is one of the common complication after thyroid surgery. Most of the palsy are recovered within immediate postoperative periods. Meticulous surgical dissection and identification of nerve may decrease the rate of RLN palsy.

Keywords: palsy, Recurrent Laryngeal Nerve, thyroid