RECURRENT LARYNGEAL NERVE INJURY; A RISK IN THYROID SURGERY

Abstract

Objective: Aim of this study was to find out the frequency of recurrent laryngeal nerve injury in different types of thyroid surgery.

Study design: An experimental study.

Place and Duration: The study was carried out at Combined Military Hospital, Rawalpindi from January 2001 to July 2002.

Patients and Method: Seventy two patients were included in this study. Case selection was done by non probability convenient sampling from surgical out patient department. Age of patients ranged between 15 years to 73 years. Mean age was 36.5 years with maximum prevalence in the range of 31-40 years (31.5%) Male to female ratio was 1:1.7. All patients were evaluated clinically and were advised preoperative routine investigation. All patients had voice analysis along with indirect laryngoscopic examination preoperatively.

Results: The commonest presenting complaint in 72 patients was lump front of neck in 69 (95.8%) patients, 48(66.7%) patients were having nontoxic goiter, 15 (20.8%) patients were having toxic goiter and 9 (12.5%) patients were having malignant goiter. Out of all thyroidectomies performed 48 (66.7%) were sub total, 18 (25 %) lobectomy with Isthmusectomy, 5 (6.9 %) were near total and 1 (1.4 %) was total thyroidectomy. Temporary recurrent laryngeal nerve injury occurred in 2 (2.8%) cases. Permanent injuries to recurrent laryngeal nerve occurred in 2 (2.8 %) cases, one patient had vocal cord paralysis and other developed vocal cord paresis which improved partially with time.

Conclusion: Recurrent laryngeal nerve injury is a potentially dangerous and a serious complication of thyroid surgery. The overall percentage of injury to recurrent laryngeal nerve in thyroid surgery in this study was 4 (5.6%) cases.