Recurrent laryngeal nerve injury: an experience with 310 thyroidectomies.

BACKGROUND Thyroid surgery has been associated with complications ranging from nerve injury to death. Improvements in techniques have reduced the mortality rate to minimum. Morbidity, however, remains a significant concern. This study was designed to determine the prevalence of recurrent laryngeal nerve (RLN) injury and duration of recovery following transient recurrent laryngeal nerve injury, during thyroid surgery. METHODS This prospective, observational study was carried out in the Surgical Department of Fauji Foundation Hospital, Rawalpindi, from January 2000 to December 2005. All patients undergoing Thyroid surgery were included. RESULTS 310 patients, predominantly female (97.09%), were operated. Majority were euthyroid (90.33%). 3.22% patients had recurrent laryngeal nerve injury. Amongst them, 87.5% had transient and 12.5% had permanent nerve lesion. Majority of the patients (87.5%) showed signs of recovery within 12 weeks after surgery. Injury was observed more in huge goiters (3.57% transient and 1.42% permanent), total thyroidectomy (7.69% transient and 3.84% permanent) and during lobectomy and total thyroidectomy (6.25% respectively for transient and permanent nerve injury. CONCLUSION Thyroid surgery should be done by experienced surgeon and care should be taken especially in huge goiters and patients undergoing total thyroidectomy.