The risk to the recurrent laryngeal nerves in thyroid and parathyroid surgery.

The incidence of vocal cord paralysis during operations on the thyroid and parathyroid glands in a single surgical unit having a special interest in this field has been reviewed over a 9-year period. 97% of all operations were reviewed, as were over 98% of nerves at risk, with a minimum follow-up period of one year in all cases of paralysis unless normal function was observed earlier. The overall rate of paralysis did not differ significantly from previous reports but analysis according to the type of goitre and surgical procedure revealed a greatly increased risk in retrosternal goitres (17.5%) and in unilateral (11.8%) as compared with bilateral resections for nodular goitre (5.2%).