Recurrent laryngeal nerve injury after thyroid surgery

Abstract

Relevance: Thyroid surgery is dangerous and can lead to damage RLN. The frequency of nerve damage varies widely and this is due to the fact that not always immediately after surgery and subsequent examination of the larynx. This leads to late start of treatment. Purpose of this research is estimate the frequency of transient and permanent immobility of the vocal folds after thуroid surgery. Materials and methods: It was prospective cohort monocenters investigate. 1364 patients were examined. We developed “voice passport of the patient” to improve the diagnosis and treatment. It included data of examination and treatment. All patients in the preoperative and postoperative periods were examination: laryngoscopy, laryngeal videoendoscopy, voice spectral analysis and Voice Handicap Index (VHI-30 modified version) by Jacobcon. Results and discussion: Postoperative disorders of motion vocal folds were in 132 (9.7%) patients. Recovery of motion vocal folds were observed in 123 patients, which were 93.2% of the total number of cases of damage RLN (132) and 9.1% of the total number of surgical interventions (1364). Lack of recovery of motion vocal folds more than one year (laryngeal paralysis) was observed in 9 patients, which was 6,8% of the total number of cases of damage RLN (132) and 0.6% of the total number of surgical interventions (1364). Conclusions: Studying the frequency of paresis and paralysis of the larynx depending on the type of surgery and predicting the risks of PGN depending on the scope of the intervention before its implementation allows to reduce the number of postoperative complications and optimize management tactics in cases where nerve injury can’t be avoided.