[Prevention of recurrent laryngeal nerve paralysis by demonstration of the nerve during thyroid surgery].

INTRODUCTION

Recurrent laryngeal nerve paralysis is one of the major complications of thyroid surgery. The importance of dissection and exploration of the recurrent laryngeal nerve during thyroid surgery remains controversial.

METHODS

74 thyroid gland operations with obligatory dissection and exploration of the recurrent laryngeal nerve were analysed.

RESULTS

118 recurrent laryngeal nerves were explorated in these operations. Transitory postoperative vocal cord paralysis was observed in 4 patients. In one patient vocal cord paralysis was permanent. This results in a transitory vocal cord paralysis rate of 3.4 % and a permanent vocal cord paralysis rate of 0.85 %.

DISCUSSION: Our results and the literature review indicate that dissection and visualization of the recurrent laryngeal nerve can reduce the risk of permanent paralysis to a minimum. Obviously mechanical trauma like compression and crushing due to dissection do not increase incidence of permanent nerval disorders. Certain dissection and identification of the recurrent laryngeal nerve during thyroid surgery is recommended in principle.