ABSTRACT
This study was conducted to assess the risk of recurrent laryngeal nerve palsy [RLNP] in different types of thyroidectomy with identification of the nerve during operation and its relation to different thyroid diseases. One hundred eighty seven patients were included in this study, 69 men and 118 women, Patients classified into four groups according to the underlying disease benign thyroid disease [n=56], Graves' disease [n=21], thyroid carcinoma [n=73], and recurrent goiter [n=37]. Of recurrent group 7 had recurrent Graves' disease, 10 had thyroid cancer, and 20 had recurrent nodular goiter. Total thyroidectomy was done in 85 patients, near total in 45, subtotal thyroidectomy in 30 and lobectomy in 27 patients. Temporary and permanent RLNP rates were analyzed for patients groups, 7 patients develop RLNP postoperatively [3.74%], recovery of nerve function was documented for 6 patients [85.7%]. recovery from temporary RLNP ranged from 5 days to 2 months [mean 27 days]. Overall incidence of temporary and permanent RLNP was 3.74% and 0.53% respectively. The rates of temporary/permanent RLNP were 0.0%, 0.0% for benign thyroid disease, 4.1%, 0.0% for thyroid cancer, 4.76%, 0.0% for Graves' disease, 5.4%, 2.7% for recurrent goiter. Surgery for thyroid cancer, Graves' disease, and recurrent goiter were associated with significantly higher RLNP rates. Temporary RLN palsy rate was not affected by the type of operation, while permanent vocal cord palsy occurred in total thyroidectomy and this attributed to recurrence more than to the type of operation. Identification of the nerve during operation does not affect the rate of RLNP