Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
A significant concern in thyroid surgery is the risk of iatrogenic injury to the Recurrent Laryngeal Nerve (RLN). One primary outcome of vocal cord paralysis is associated with thyroidectomy. This study aims to evaluate the incidence of RLN injury in patients undergoing thyroid surgery using data from a single institution and to investigate the factors contributing to RLN injury during these procedures. A retrospective review was conducted on 78 patients who had thyroid surgery at the ENT and Surgery departments. Patient records were assessed for history, physical examination, thyroid function tests and surgical reports to determine the type of surgery (total, near‐total, or subtotal thyroidectomy) and RLN identification. Cases were classified as primary (no prior thyroid surgery) or secondary (one or more prior surgeries). RLN injury was evaluated in relation to gender, surgical type, category and histological diagnosis. Vocal cord paralysis or dysphonia was deemed permanent if lasting over six months and temporary if resolved sooner. In this cohort, the recurrent laryngeal nerve was successfully identified in 8 patients (33.33%), whereas it was not identified in the remaining 16 patients. Transient RLN injury was observed in 14 patients and 10 patients experienced chronic RLN damage. Temporary vocal cord paresis occurred in 9 patients (11.53%), with 3 cases being bilateral. The incidence of RLN injury was significantly higher in postoperative cases involving malignancy (23.08% in malignant conditions versus 7.69% in benign conditions) and in cases where the RLN was not identified during surgery (10.26% when identified versus 20.51% when not identified). The meticulous dissection and identification of the RLN during thyroid surgery may help mitigate the risk of iatrogenic nerve injury. The study highlights a significantly increased risk of operative RLN damage associated with thyroid cancer, repeat surgeries for recurrent goiter, and the failure to identify the RLN intraoperatively.
How to cite this article:
Rajesh Roat, Namrata Khandelwal, Vidushee Upadhyay and Pradeep Balmiki. Risk Assessment of Recurrent Laryngeal Nerve Injury in Thyroid Surgery: A Retrospective Analysis.
DOI: https://doi.org/10.36478/10.36478/makrjms.2024.7.610.613
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2024.7.610.613