Vocal Fold Paralysis with Intraoperative Recurrent Laryngeal Nerve Identification versus Non-identification of Recurrent Laryngeal Nerve in Total Thyroidectomy: A Retrospective Cohort Study

Authors

  • Andrie Jeremy Formanez Department of Otorhinolaryngology Head and Neck Surgery Armed Forces of the Philippines Medical Center Quezon City, Philippines

DOI:

https://doi.org/10.32412/pjohns.v31i1.307

Keywords:

cranial nerve injuries/prevention and control, recurrent laryngeal nerve injuries, thyroid neoplasms/surgery, thyroidectomy/adverse effects, vocal cord paralysis/prevention control, Andrie Jeremy

Abstract

Objective: To determine the risk of vocal fold paralysis in patients who underwent total thyroidectomy with and without intraoperative recurrent laryngeal nerve identification.

Methods:

            Study design:             Retrospective cohort study

            Setting:                       Tertiary military hospital

            Population: 237 adult patients who underwent total thyroidectomy for benign lesions based on post-operative histopathology operated on by senior third or fourth year residents. Excluded were those who underwent lobectomy with isthmusectomy or reoperation/completion thyroidectomy, had intrathoracic goiters, confirmed malignancies based on post-operative histopathology, or cases wherein the RLN had to be sacrificed due to gross involvement of the nerve caused by malignancy.

Results: Group A, wherein intraoperative identification of RLN was done, had a temporary and permanent RLN injury incidence of 2.75% and 0.92% respectively. Group B, wherein intraoperative identification of RLN was not done, had a temporary and permanent RLN injury incidence of 17.19% and 12.5% respectively.  Through binary linear regression, the probability of having temporary paralysis increases almost two-fold if the nerve is not identified, and the probability of having permanent paralysis increases by almost nine-fold if the nerve is not identified.

Conclusion: We recommend routine intraoperative RLN identification, which has a lower risk for temporary and permanent vocal fold paralysis when compared to non-identification of the RLN.

Keywords: cranial nerve injuries/prevention and control, recurrent laryngeal nerve injuries, thyroid neoplasms/surgery, thyroidectomy/adverse effects, vocal cord paralysis/prevention control

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Published

2016-06-24

How to Cite

1.
Formanez AJ. Vocal Fold Paralysis with Intraoperative Recurrent Laryngeal Nerve Identification versus Non-identification of Recurrent Laryngeal Nerve in Total Thyroidectomy: A Retrospective Cohort Study. Philipp J Otolaryngol Head Neck Surg [Internet]. 2016 Jun. 24 [cited 2024 Nov. 24];31(1):22-5. Available from: https://pjohns.pso-hns.org/index.php/pjohns/article/view/307

Issue

Vol. 31 No. 1 (2016): Philippine Journal of Otolaryngology-Head and Neck Surgery

Section

Original Articles

License

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