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Recurrent Laryngeal Nerve Injury Near the Nerve Entry Point in Total Endoscopic Thyroidectomy: A Retrospective Cohort Study

Overview
Publisher Dove Medical Press
Specialty Oncology
Date 2021 Dec 9
PMID 34880678
Citations 2
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Abstract

Background: Recurrent laryngeal nerve injury (RLNI) still occurs in total endoscopic thyroidectomy (TET) by using intraoperative neuromonitoring (IONM). As the region where most injuries occur, more attention should be paid to RLNI near the nerve entry point (NEP) in TET.

Materials And Methods: This cohort study collected retrospectively data from 415 patients who underwent TET between February 2012 and December 2019. The functions of the recurrent laryngeal nerve (RLN) in TET were recorded by IONM. The patients with RLNI near the NEP were followed up by laryngoscopies. The demographic and clinical characteristics, the mechanisms of RLNI, and the outcomes of RLNI were recorded and analyzed.

Results: There were a total of 444 at-risk nerves in 405 patients were analyzed. The incidence of RLNI near the NEP was 7.9%. RLNs with extralaryngeal branches were more likely to be injured near the NEP (P = 0.037). The incidences of different types of RLNI, in order of frequency, were 68.8% for thermal injury (n = 22), 28.1% for traction/compression injury (n = 9), and 3.1% for transverse injury (n = 1). A total of 93.8% (n = 30) of RLNI patients had complete recovery of vocal cord activity function.

Conclusion: The extralaryngeal branch was a risk factor for RLNI near the NEP in TET. Thermal injury caused by an ultrasonic scalpel was the most common cause of RLNI near the NEP. Most RLNIs near the NEP would eventually recover.

Citing Articles

Comparison of Recurrent Laryngeal Nerve Insult Incidence Post Thyroidectomy for Benign and Malignant Lesions.

Haddadin S, Mahasna A, Abumekhleb I, Almaaitah F, Alhyari F, Alsaidat Y Med Arch. 2023; 77(3):213-217.

PMID: 37700914 PMC: 10495145. DOI: 10.5455/medarh.2023.77.213-217.


Mechanisms of recurrent laryngeal nerve injury in endoscopic thyroidectomy for papillary thyroid carcinoma: A large data from China.

Xu W, Teng C, Ding G, Zhao N Laryngoscope Investig Otolaryngol. 2023; 8(2):604-609.

PMID: 37090890 PMC: 10116958. DOI: 10.1002/lio2.1043.

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