TY - JOUR
T1 - Prevention of complications in thyroid surgery recurrent laryngeal nerve injury personal experience on 313 cases
AU - Li Volsi, F.; Modica, G.
AU - Sciume', Carmelo
AU - Geraci, Girolamo
AU - Pisello, Franco
AU - Facella, Tiziana
PY - 2005
Y1 - 2005
N2 - Introduction: Thyroidectomy poses many challenges for the surgeon who undertakes endocrine surgery and iatrogenic injury of inferior laryngeal nerve (ILN) is one of the most serious (0-20%). We report our personal experience of a series of 313 thyroidectomy with intraoperative identification of ILN. Methods: 313 patients (253 females, 60 males, whose age was between 17 and 86 years, mean 41 years) had undergone thyroidectomy in our Operative Unit from January 2000 to January 2004. Among them, 259 patients underwent total extracapsular thyroidectomy, 38 subtotal thyroidectomy, 5 istmo-lobectomy and 11 were completions of thyroidectomy in patients who had previously undergone a first thyroid surgical intervention. Results: We identified 588 ILN (in all cases), in the left or in the right side only in case of istmo-lobectomy or completion of thyroidectomy. In two cases (0.63%) we noticed on the right side a non recurrent laryngeal nerve. Concerning the postoperative results we noticed only one case (0.38%) of ILN injury with monolateral cordai hypo-motility and temporary disphonia, actually on phoniatric therapy at follow-up. Conclusion: A strong knowledge of the anatomy and embryology of the thyroid region, a commitment to meticulous attention to detail, the awareness of the extremely varying course of the ILN and the inferior thyroid artery and their relations, and adequate experience are all required to maintain a level of expertise and avoid ILN. Thyroid carcinoma, recurrent goitre, total thyroidectomy operation, duration of the operation are factors which increase the risk of postoperative ILN injury.
AB - Introduction: Thyroidectomy poses many challenges for the surgeon who undertakes endocrine surgery and iatrogenic injury of inferior laryngeal nerve (ILN) is one of the most serious (0-20%). We report our personal experience of a series of 313 thyroidectomy with intraoperative identification of ILN. Methods: 313 patients (253 females, 60 males, whose age was between 17 and 86 years, mean 41 years) had undergone thyroidectomy in our Operative Unit from January 2000 to January 2004. Among them, 259 patients underwent total extracapsular thyroidectomy, 38 subtotal thyroidectomy, 5 istmo-lobectomy and 11 were completions of thyroidectomy in patients who had previously undergone a first thyroid surgical intervention. Results: We identified 588 ILN (in all cases), in the left or in the right side only in case of istmo-lobectomy or completion of thyroidectomy. In two cases (0.63%) we noticed on the right side a non recurrent laryngeal nerve. Concerning the postoperative results we noticed only one case (0.38%) of ILN injury with monolateral cordai hypo-motility and temporary disphonia, actually on phoniatric therapy at follow-up. Conclusion: A strong knowledge of the anatomy and embryology of the thyroid region, a commitment to meticulous attention to detail, the awareness of the extremely varying course of the ILN and the inferior thyroid artery and their relations, and adequate experience are all required to maintain a level of expertise and avoid ILN. Thyroid carcinoma, recurrent goitre, total thyroidectomy operation, duration of the operation are factors which increase the risk of postoperative ILN injury.
KW - Recurrent Laryngeal Nerve; Thyroidectomy; inferior laryngeal
UR - http://hdl.handle.net/10447/24419
M3 - Article
VL - 76
SP - 23
EP - 28
JO - Annali Italiani di Chirurgia
JF - Annali Italiani di Chirurgia
SN - 0003-469X
ER -