Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery · 2014
[Recurrent laryngeal nerve decompression for bilateral recurrent laryngeal nerve paralyses after thyroid surgery].
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Lyu Zhenghua, Xu Wei, Zou Jidong, Feng Shouhao, Cao Hongyuan
Аннотация
OBJECTIVE: To study the feasibility and therapeutic effect of recurrent laryngeal nerve (RLN) decompression in the treatment of bilateral paralyzed RLN after thyroid surgery.
METHODS: From March 2005 to June 2013, 15 cases of bilateral RLN paralyses occurring within 3 months after thyroid surgery were treated with RLN decompression. Bilateral RLN paralyses were caused by revised thyroid surgery in 8 cases and by primary thyroid surgery in 7 cases.
RESULTS: RLN injuries were found in 15 cases/22 side, including RLN-cut in 9 sides and RLN-ligated in 13 sides. RLN decompression was performed in the 10 cases/13 sides of ligated RLN. Vocal cord mobility was detected through electrolaryngoscope for evaluating the postoperative functional recovery of decompressed RLN.Of 8 patients with bilateral RLN paralyses due to the ligation of RLN after previous revised thyroid surgeries, functional adduction and abduction of the vocal cord was recovered completely in 4 patients and recovered basically with a slight weak abduction in one patient after RLN decompression, and the 5 patients were decannulated in 1-4 months postoperatively. For 7 patients with bilateral RLN paralyses resulted from previous primary surgeries, unilateral or bilateral RLN decompress was performed in 2 cases and in 3 cases respectively. The mobility of the paralyzed vocal cord restored in 1-6 months after RLN decompression, besides one case with relative deficient abduction and one case with slight limited abduction and adduction, and the 5 patients were decannulated successfully.
CONCLUSION: Exploration surgery could be performed as soon as possible in patients with bilateral RLN paralyses and RLN decompress is effective for the restoration of the function of the nerve.
METHODS: From March 2005 to June 2013, 15 cases of bilateral RLN paralyses occurring within 3 months after thyroid surgery were treated with RLN decompression. Bilateral RLN paralyses were caused by revised thyroid surgery in 8 cases and by primary thyroid surgery in 7 cases.
RESULTS: RLN injuries were found in 15 cases/22 side, including RLN-cut in 9 sides and RLN-ligated in 13 sides. RLN decompression was performed in the 10 cases/13 sides of ligated RLN. Vocal cord mobility was detected through electrolaryngoscope for evaluating the postoperative functional recovery of decompressed RLN.Of 8 patients with bilateral RLN paralyses due to the ligation of RLN after previous revised thyroid surgeries, functional adduction and abduction of the vocal cord was recovered completely in 4 patients and recovered basically with a slight weak abduction in one patient after RLN decompression, and the 5 patients were decannulated in 1-4 months postoperatively. For 7 patients with bilateral RLN paralyses resulted from previous primary surgeries, unilateral or bilateral RLN decompress was performed in 2 cases and in 3 cases respectively. The mobility of the paralyzed vocal cord restored in 1-6 months after RLN decompression, besides one case with relative deficient abduction and one case with slight limited abduction and adduction, and the 5 patients were decannulated successfully.
CONCLUSION: Exploration surgery could be performed as soon as possible in patients with bilateral RLN paralyses and RLN decompress is effective for the restoration of the function of the nerve.