Vocal Fold Paralysis with Intraoperative Recurrent Laryngeal Nerve Identification versus Non-identification of Recurrent Laryngeal Nerve in Total Thyroidectomy: A Retrospective Cohort Study
| Autor: | Andrie Jeremy Formanez |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: | |
| Zdroj: | Philippine Journal of Otolaryngology Head and Neck Surgery, Vol 31, Iss 1 (2016) |
| Druh dokumentu: | article |
| ISSN: | 1908-4889 2094-1501 |
| DOI: | 10.32412/pjohns.v31i1.307 |
| Popis: | 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 |
| Databáze: | Directory of Open Access Journals |
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