Non – Exploration of the Recurrent Laryngeal Nerve in Thyroid Surgery

Abstract

Background: Goiter is a common disease in Iraq and it is more common in the North .The disease is more common in females than in males. For this reason thyroid surgery is a common procedure. Many complications occur during and after surgery such as; bleeding, hypothyroidism, and recurrent laryngeal nerve injury.The later complication, although infrequently encountered can cause a lot of suffering to the patient. Objective: The objective of our study is assessing injury to the recurrent laryngeal nerve without exploration of the nerve routinely during thyroid surgery. exploration of the nerve done for selected cases where there is increase risk to injury. Patients and method: Prospective study of 400 patients whom underwent different thyroid surgery for different thyroid diseases done by one surgeon from July 1992 to July 2012 in Baquba teaching hospital were analyzed for permanent injury to RLN , when non-exploration of the RLN is the rule. Result: from the 400 cases included in the study only 4 cases (1%) had permanent injury to the RLN, 6 cases (1.5%) had transient injury and no injury in 390 cases (97.5%). Conclusion: Exploration of the RLN is not necessarily to be done routinely during thyroid surgery. We recommend exploration of the nerve in selected thyroid diseases