Short term Outcomes of Routine Exposure Versus non Exposure of the Recurrent Laryngeal Nerve During Thyroidectomy for Benign Thyroid Diseases

Radwan Abdelsabour Torky; Mohamed Abdel-Tawab; Mohammed M Hussein

doi:10.1007/s12070-023-03763-9

Short term Outcomes of Routine Exposure Versus non Exposure of the Recurrent Laryngeal Nerve During Thyroidectomy for Benign Thyroid Diseases

Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1974-1980. doi: 10.1007/s12070-023-03763-9. Epub 2023 Apr 21.

Authors

Radwan Abdelsabour Torky¹, Mohamed Abdel-Tawab², Mohammed M Hussein¹

Affiliations

¹ Department of Surgery, main hospital, Assiut Faculty of medicine, Assiut University, Assiut, Egypt.
² Department of diagnostic and interventional radiology, main hospital, Assiut Faculty of medicine, Assiut University, Assiut, Egypt.

PMID: 37636666
PMCID: PMC10447871 (available on 2024-09-01)
DOI: 10.1007/s12070-023-03763-9

Abstract

Aims: To evaluate the outcomes of the exposure versus non-exposure of the RLN during thyroidectomy for benign thyroid diseases.

Materials and methods: A prospective study for patients who underwent thyroidectomy for benign diseases. They were classified into two groups, group 1 (the exposed group) and group 2 (the non-exposed group) of the RLN. History, examination, laboratory and radiological investigations as well as intra and post-operative details were recorded.

Results: 97 patients were included in the study, group 1 (63 patients) while group 2 (34 patients). The median age of both groups was 40 (for group 1) and 42 (for group 2) respectively. There was no significant difference regarding the gender of the patients (P = 0.089) and the type of surgery (P = 0.234). The duration of surgery as well as the amount of intraoperative blood loss were equal with no significant difference (P = 0.791) (P = 0.225). Hematoma was detected in three patients in the exposed group while RLN injury was detected in 5 patients in total (2 in group 1 and 3 in group 2) without any significant difference. There was significant hypocalcemia in favor of the non-exposed group (P = 0.001). Regarding the postoperative hospital stay, there was no significant difference between both groups (P = 0.720).

Conclusions: Exposure versus non-exposure of the RLN is still considered a matter of debate but precautions during dissection are a very useful maneuver. Meanwhile, it is better to expose the nerve with meticulous dissection and preservation of the parathyroid gland vascularity.

Keywords: Exposure; RLN injury; Thyroidectomy.

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