Abstract:Objective:To investigate the therapeutic effect of operation for the recurrent larygeal nerve (RLN) injury caused by thyroid operation.
Methods :Fiftyseven cases of RLN injury caused by thyroid operation during past 38 years and its causes, location, types and curative effect were retrospectively analyzed.
Results:Amony the 57 cases, 4 had bilateral RLN injury, thus injury occurred in a total of 61 RLNs. TwentySeven RLN injuries occurred on the right side and 34 on the left side. The operation which resulted in RLN injury included 26 thyroid lobectomies(42.6%), 30 subtotal thyroidectomies(49.2%) and 5 thyroid adenoma or cyst enucleation（8.2%）. The RLN injuries were located within 2cm below the point of RLN entering to throat in 49 nerves (80.3%), and at other places in 12 nerves(19.7%). Transection of the nerve was found in 23 nerves (37.7%), and suture or scar pressure of the nerve in 37 nerves（62.3%）. After operative treatment of the RLN injury, 51 cases (89.5%) were followed up for more than 1 year. Among the 51 followed-up patients, phonation was restored to normal or obvious improvement in 49 cases (96.1%), and improvement in 2 (3.9%). Of the 42 patients with 46 RLN injury who underwent indirect or direct laryngoscopy, the affected vocal cord movement completely recovered in 26 vocal cords (56.5%), partially recovered in 8 vocal cords(17.4%), and no recovery was found in 12 vocal cords (26.1%). In all the 4 patients who underwent tracheotomy, the tubes were withdrawn before discharge. There was no relation between the recovery of phonation or vocal cord movement with the timing or the mode of reparative operation.
Conclusions:The location of most RLN injuries caused by thyroid surgery is just below the point of RLN entrance into the throat. Surgical operation is a sure and effective way to deal with RLN injury caused by thyroid operation.