ArticleIndian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India2023
An Exposition on Surgical Experiences in Identification, Exposure, and Injuries of Recurrent Laryngeal Nerve (RLN) During Thyroid Operations: Gleanings, Narrative, and the Reflections.
Article in Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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- Surgical anatomy of the recurrent laryngeal nerve: a systematic review and meta-analysis of variants.Langenbeck's archives of surgery · 2026Pooled it
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4 authors at 2 institutions in 1 country.
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Abstract
backgroundIdentifying and preserving the recurrent laryngeal nerve (RLN) is of paramount importance during thyroid surgeries. Iatrogenic injuries to RLN (RLNI) are considered one of the most serious and feared complications of thyroidectomies. Surgically, there are four routes/approaches (lateral, inferior, superior, and medial) for localizing and identifying the RLN. This study aims to estimate the incidence of RLNI in the context of various approaches taken intra-operatively for nerve localization and identification. MATERIALS AND
methodsThis retrospective analytical study included 54 cases of thyroidectomies operated for various benign and malignant thyroid disorders in a tertiary care center from January 2018 to December 2020. Intraoperative search, identification, and dissection of the nerve were done with superior, inferior, medial, and lateral approaches. The chi-square test and exact test were used to analyze the data and p-value < 0.05 was considered significant. Pre- and post-operative recurrent laryngeal nerve evaluation was done with 90 degrees Hopkins laryngoscope.
resultsOverall in this series, the incidence of post-thyroidectomy RLNI was 3.7% and 3.7% for permanent and temporary nerve insults, respectively. Non-recurrent RLN on the right side was identified in one case and extra-laryngeal branching of RLN was identified in two cases. There was no statistically significant difference (p = 0.929) between the different approaches taken and the incidence of RLNI. The type of surgery and pathology also expressed no statistically significant relevance with the incidence of RLNI (p = 0.463 and p = 0.277, respectively).
conclusionAdoption of a particular surgical approach to localize and identify RLN during thyroid surgery carries no statistically significant difference between RLNI and approaches taken. Meticulous handling and dissection of the tissue in the correct surgical plane are crucial determinants in preventing RLNIs.
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