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. 2014 Jan 15;7(1):101-7.
eCollection 2014.

Prevention and treatment of recurrent laryngeal nerve injury in thyroid surgery

Yan Jiang  1 , Bo Gao  1 , Xiaohua Zhang  1 , Jianjie Zhao  1 , Jinping Chen  1 , Shu Zhang  1 , Donglin Luo  1
Affiliations

Prevention and treatment of recurrent laryngeal nerve injury in thyroid surgery

Yan Jiang et al. Int J Clin Exp Med. .

Abstract

Aim: To summary the experience for prevention and treatment of recurrent laryngeal nerve (RLN) injury in thyroid surgery.

Methods: Clinical features of 623 patients who received thyroid surgery from January 2010 to December 2012 were analyzed retrospectively, and the features of RLN injury and intraoperative as well as postoperative treatments were reviewed.

Results: RLN injury occurred in 31 patients (4.98%), in which, unilateral RLN injury occurred in 27 patients and bilateral RLN injuries occurred in 4 patients (temporary injury in 28 patients and permanent injury in 3 patients). 6 patients underwent RLN anastomosis during surgery and exhibited transient hoarseness after surgery. RLN exploration and decompression was given in 1 patient and the patient got normal vocal cord motion 2 months after surgery. 1 patient with bilateral injuries received tracheotomy and CO2 laser resection of arytenoid cartilage and achieved recovery 1 year later.

Conclusions: In order to prevent RLN injury, the anatomic variations of RLN should be mastered. Routine exposure of RLN can effectively prevent the injury in patients receiving the second or multiple surgeries. Early interventions for RLN injury include mainly early discovery, early exploration and early anastomosis, and the function of RLN in some patients can recover completely. Subsequent treatments mainly focus on the improvement of the voice, expansion of glottis and melioration of dyspnea.

Keywords: Thyroid surgery; prevention; recurrent laryngeal (RLN) injury; treatment.

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Figures

Figure 1
Figure 1
The normal opening and closing of bilateral vocal cords. A. Opening of vocal cords; B. Closing of vocal cords.
Figure 2
Figure 2
Exposing RLN during the surgery (A-C, arrow: RLN).
Figure 3
Figure 3
Limited vocal cord movement after RLN injury. A. Good movement of the right vocal cord; B. Fixation and poor closure in the left vocal cord; C. Good movement of the left vocal cord; D. Fixation and poor closure in the right vocal cord.
Figure 4
Figure 4
RLN anastomosis (arrow: RLN).
See this image and copyright information in PMC

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