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© 2013. This article is published under (http://creativecommons.org/licenses/by-nc-sa/3.0/) (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

To determine the value of dissecting the recurrent laryngeal nerve during thyroid surgery with respect to preventing recurrent laryngeal nerve injury, we retrospectively analyzed clinical data from 5 344 patients undergoing thyroidectomy. Among these cases, 548 underwent dissection of the recurrent laryngeal nerve, while 4 796 did not. There were 12 cases of recurrent laryngeal nerve injury following recurrent laryngeal nerve dissection (injury rate of 2.2%) and 512 cases of recurrent laryngeal nerve injury in those not undergoing nerve dissection (injury rate of 10.7%). This difference remained statistically significant between the two groups in terms of type of thyroid disease, type of surgery, and number of surgeries. Among the 548 cases undergoing recurrent laryngeal nerve dissection, 128 developed anatomical variations of the recurrent laryngeal nerve (incidence rate of 23.4%), but no recurrent laryngeal nerve injury was found. In addition, the incidence of recurrent laryngeal nerve injury was significantly lower in patients with the inferior parathyroid gland and middle thyroid veins used as landmarks for locating the recurrent laryngeal nerve compared with those with the entry of the recurrent laryngeal nerve into the larynx as a landmark. These findings indicate that anatomical variations of the recurrent laryngeal nerve are common, and that dissecting the recurrent laryngeal nerve during thyroid surgery is an effective means of preventing nerve injury.

Research Highlights

(1) This retrospective clinical controlled study demonstrated that dissecting the recurrent laryngeal nerve during thyroid surgery is clinically significant for preventing nerve injury.

(2) Dissecting the recurrent laryngeal nerve during thyroid surgery can effectively prevent nerve injury in the presence of anatomical variations.

(3) The inferior parathyroid gland is an optimal anatomical landmark for locating the recurrent laryngeal nerve during thyroid surgery.

(4) The middle thyroid vein is also an important anatomical landmark of dissecting the recurrent laryngeal nerve.

Details

Title
Routine exposure of recurrent laryngeal nerve in thyroid surgery can prevent nerve injury
Author
Shen, Chenling 1 ; Xiang, Mingliang 1 ; Wu, Hao 1 ; Ma, Yan 1 ; Chen, Li 1 ; Cheng, Lan 1 

 Department of Otolaryngology & Head and Neck Surgery, Ear Institute, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092 
Pages
1568-1575
Publication year
2013
Publication date
Jun 2013
Publisher
Medknow Publications & Media Pvt. Ltd.
ISSN
16735374
e-ISSN
18767958
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2382785255
Copyright
© 2013. This article is published under (http://creativecommons.org/licenses/by-nc-sa/3.0/) (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.