Risk factors for recurrent laryngeal nerve palsy after thyroidectomy

• Autorzy: Petr Čelakovský , Jan Vokurka , Lukáš Školoudík , Petr Kordač , Eva Čermáková
• Języki publikacji: EN

Abstrakty

EN

This study investigates the incidence of temporary and permanent recurrent laryngeal nerve palsy (RLNP) and possible risk factors for patients with different types of thyroid gland diseases. 1224 consecutive patients who underwent thyroidectomy for treatment of various thyroid diseases between the years 2001–2005. The rates of RLNP were evaluated. The surgeon and type of thyroid gland disorder were recognised as possible risk factors for RLNP. The incidence of temporary/permanent RLNP for the whole group was 4.5/0.8%. The rates of temporary RLNP for groups, classified as multinodular goitre, Graves’ disease, thyroid cancer or Hashimoto’s disease were 4.3%, 4.3%, 5.2% and 5.7%, respectively. The rates of permanent RLNP for the same groups were 0.4%, 0.9%, 1.6% and 1.9%, respectively. The frequency of temporary RLNP for individual surgeons ranges from 2.8 to 7.0% and the rates of permanent RLNP is between 0–3.1%. There was no relationship between the surgeon’s experience (the number of procedures performed) and RLNP rates. Total thyroidectomy is a safe procedure associated with a low incidence of RLNP not only for benign multinodular goitre, but also for Graves’disease, thyroid cancer and Hashimoto’s disease. The rates of RLNP among individual surgeons are acceptable with small inter-individual differences.

Słowa kluczowe

EN

Thyroid gland surgery; Recurrent laryngeal nerve palsy

• Czasopismo: Open Medicine
• Rocznik: 2011
• Tom: 6
• Numer: 3
• Strony: 279-283

Daty

wydano

2011-06-01

online

2011-04-08

Twórcy

autor

Petr Čelakovský

• ENT Department, Faculty of Medicine and University Teaching Hospital of Charles University, 500 05, Hradec Králové, Czech Republic,

autor

Jan Vokurka

• ENT Department, Faculty of Medicine and University Teaching Hospital of Charles University, 500 05, Hradec Králové, Czech Republic

autor

Lukáš Školoudík

• ENT Department, Faculty of Medicine and University Teaching Hospital of Charles University, 500 05, Hradec Králové, Czech Republic

autor

Petr Kordač

• ENT Department, Faculty of Medicine and University Teaching Hospital of Charles University, 500 05, Hradec Králové, Czech Republic

autor

Eva Čermáková

• Department of Biophysics, Faculty of Medicine and University Teaching Hospital of Charles University, 500 05, Hradec Králové, Czech Republic

Bibliografia

• [1] Altorjay Á., Tihanyi Z., Luka F., Juhász A., Bencsik Z, Rúll M. et al., Place and value of the Recurrent Laryngeal Nerve (RLN) palpatory method in preventing RLN palsy during thyroid surgery, Head and Neck 2009, 31, 538–647 http://dx.doi.org/10.1002/hed.20996[Crossref]
• [2] Efremidou E.I., Papageorgiou M.S., Liratzopoulos N. Manolas K.J., The efficacy and safety of total thyroidectomy in the management of benign thyroid disease: A review of 932 cases, Can. J. Surgery, 2009, 52, 39–44
• [3] Jeannon J.P., Orabi A.A., Bruch G.A., Abdalsalam H.A., Simo R., Diagnosis of recurrent laryngeal nerve palsy after thyroidectomy: A systematic review, Int. J. Clin. Pract. 2009, 63, 634–629 http://dx.doi.org/10.1111/j.1742-1241.2008.01875.x[WoS][Crossref]
• [4] Sywak M.S., Yeh M.W., Sidhu S.B., Barraclough B.H., Delbridge L.W., New surgical consultants: Is there a learning curve?, Aust. NZ. J. Surgery, 2006, 76, 1081–1084 http://dx.doi.org/10.1111/j.1445-2197.2006.03950.x[Crossref]
• [5] Chiang F.Y., Wang L.F., Huang Y.F., Lee K.W., Kuo W.R., Recurrent laryngeal nerve palsy after thyroidectomy with routine identification of the recurrent laryngeal nerve, Surgery, 2005, 137, 342–347 http://dx.doi.org/10.1016/j.surg.2004.09.008[Crossref]
• [6] Chiang F.Y., Lin J.C., Wu C.W., Lee K.W., Lu S.P., Kuo W.R. et al., Morbidity after total thyroidectomy for benign thyroid disease: Comparison of Graves’ disease and non-Graves’ disease, Kaohsiung J. Med. Sci., 2006, 22, 554–559 http://dx.doi.org/10.1016/S1607-551X(09)70352-3[Crossref]
• [7] Erbil Y., Barbaros U., Issever H., Borucu I., Salmasliolu A., Mete O., et al., Predictive factors for recurrent laryngeal nerve palsy and hypoparathyroidism after thyroid surgery, Clin. Otolaryngol., 2007, 32, 32–37 http://dx.doi.org/10.1111/j.1365-2273.2007.01383.x[Crossref]
• [8] Sevim T., Risk factors for permanent laryngeal nerve paralysis in patients with thyroid carcinoma, Clin. Otolaryngol., 2007, 32, 378–383. http://dx.doi.org/10.1111/j.1749-4486.2007.01536.x[WoS][Crossref]
• [9] Atallah I., Dupret A., Carpentier A.S., Weingertner A.S., Volkmar P.P., Rodier J.F., Role of intraoperative neuromonitoring of the recurrent laryngeal nerve in high-risk thyroid surgery, J. Laryngol. Head Neck Surg., 2009, 38, 613–618
• [10] Chiang F.Y., Lu I.C., Kuo W.R., Lee K.W., Chang N.C., Wu C.W., The mechanism of recurrent laryngeal nerve injury during thyroid surgery - the application of intraoperative neuromonitoring, Surgery, 2008, 143, 743–749 http://dx.doi.org/10.1016/j.surg.2008.02.006[Crossref]
• [11] Barczynsky M., Konturek A., Cichon S., Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy, Br. J. Surg., 2009, 96, 240–246 http://dx.doi.org/10.1002/bjs.6417[Crossref]
• [12] Aytac B., Karamercan A., Recurrent laryngeal nerve injury and preservation in thyroidectomy, Saudi Med. J., 2005, 26, 1746–1749
• [13] Emre A.U., Cakmak G.K., Tascilar O., Ucan B.H., Irkorucu O., Karakaya K. et al., Complications of total thyroidectomy performed by surgical residents versus specialist surgeons, Surg. Today, 2008, 38, 879–885 http://dx.doi.org/10.1007/s00595-008-3760-4[Crossref][WoS]

Identyfikatory

DOI

10.2478/s11536-011-0018-0