Correlation Between Types of Thyroid Surgery, Goitre Pathology, and Recurrent Laryngeal Nerve Injury-Retrospective Cohort Study

Author(s): Ali M AlSaiegh

Background: Thyroidectomies are commonly practiced surgical operations involve removal of a part or whole of the gland as suitable to the type and the pathology of goiter. This is to estimate the recurrent laryngeal nerve injury concerning different types and indications of thyroid surgery.

Patients and Methods: A cohort retrospective study of 705 patients with different kinds of goiters admitted to Al-Sadder teaching hospital and Al-Ameer private hospital in Najaf city- Iraq, for thyroid surgery, as a single surgeon experience, from 1 October 2007 to 30 June 2018, with 37 months as a mean follow uptime. Details regarding patient’s data, types of thyroid operations and goiter’s pathology recorded with consideration to recurrent laryngeal nerve injury.

Results: Seven hundred and five patients with different types of thyroidectomies for different indications. The patient’s age ranged from 11 to 80 years. Most of the patients have non-toxic multinodular goiters (67.4%); the second most common indication for surgery was for toxic multinodular goiters that have seen in (19.15%). Malignancy was seen in (14.3%), while Hashimoto's thyroiditis and Grave’s disease were the least common indications of surgery in our study constituting (7.6%, 3.4%) respectively. Temporary recurrent laryngeal nerve injuries were seen in (0.69%) of subtotal surgery rising to (10%) (p=0.05), for patients having recurrent goiters. The overall permanent recurrent laryngeal nerve injuries were (0.99%) ranging from (0%) in subtotal up to (5%) (p=0.027) in cases for recurrent goiters.

Conclusion: Although subtotal thyroidectomy is associated with a low rate of recurrent laryngeal nerve injury, total thyroidectomy is preferable because it will reduce the need for redo surgery that accompanied by a significantly high rate of nerve injury.

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