ABSTRACT

Thyroidectomy is one of the commonly performed operations with low mortality rates; however it has complications such as bleeding, injury of recurrent nerve and parathyroid gland causing serious morbidity. It is still controversial whether the recurrent nerve should be identified and preserved during thyroidectomy.

In this study 244 cases performed thyroidectomy with routine recurrent nerve dissection in Bak›rkoy Dr. Sadi Konuk Training and Research Hospital between January 2001 and February 2004 were evaluated regarding temporary and permanent recurrent nerve injury in the light of the literature.

Of these 244 cases 209 were female and 35 were male with a mean age of 43.36 years. Mean follow up was 15 months and mean hospital stay was 2.5 days. Preoperative diagnosis was multinodular goiter in 222 cases, thyroid carcinoma in 11 cases, diffuse toxic goiter in 6 cases and follicular neoplasia in 5 cases. Choice of operation was bilateral subtotal thyroidectomy in 114 cases, unilateral total thyroidectomy in 49 cases, unilateral total and unilateral subtotal thyroidectomy in 48 cases and bilateral total thyroidectomy in 33 cases. Mean operation time was 73 minutes. In early postoperative period symptoms suggesting recurrent nerve injury developed in 10 cases as hoarseness in 8 cases and hoarseness accompanied with respiratory distress in 2 cases. Control laryngoscopies performed at the end of the first postoperative month revealed recurrent nerve paralysis in 3 of the cases but at the control by the end of the sixth postoperative month 2 of these cases were improved.

We suggest that routine nerve dissection may decrease recurrent nerve injury during performing thyroidectomy.

Keywords: Thyroidectomy, nerve dissection