Identification of recurrent laryngeal nerve during thyroidectomy decreases the risk of nerve injury

ABSTRACT

To determine the effect of Recurrent Laryngeal Nerve [RLN] exposure on the incidence of nerve injury, and compare the injury rate with that when nerve is not exposed during thyroid surgery. This prospective observational study was carried out in department of general surgery, at Liaquat University of Medical and Health Sciences, Jamshoro, from January 2005 to December 2006. A total of 120 patients were included, with 24 males and 96 females [male female of 1 4]. Mean age of our patients was 30.85 years [range 14-68 years]. The different surgical procedures, performed on thyroid gland included total thyroidectomy 23, near total thyroidectomy 58, subtotal thyroidectomy 28, and hemi-thyroidectomy 11. The RLN was exposed in 60 patients, in other group of 60 patients thyroidectomy was carried out without exposing RLN, and incidence of nerve injury was compared between two groups. RLN identification decreased the nerve injury incidence from 5% to 1.6%. When recurrent laryngeal nerve is not identified during thyroid surgery the chance to incur damage to RLN is statistically significant [Chi square at 1df 0.000] We believe that RLN identification during thyroidectomy would be the best approach to avoid nerve injury