[Recurrent laryngeal nerve paralysis after thyroidectomy]

The paper's aim is to examine and analyse the incidence rate of postoperative pareses of N. recurrens in 1311 operated thyroid sides and 909 patients.

In histology we found nodular changes in 92.6% of 840 operated benignant strumata. In 69 malignant strumata the papillary thyroid carcinoma was the most common. The surgical concept changed within the last years from subtotal resections and enuclations to functional and total resections.

Preoperative pareses of N. recurrens were seen in 5.3% of the patients, which emphasizes the demand for a preoperative laryngologic examination. Surgery on relapsed benignant strumata were followed by permanent unilateral pareses of N. recurrens in 9.9%, surgery on malignant strumata in 7.5% of the cases. After surgery of relapsed malignant strumata we found 2 permanent pareses in 21 reoperated thyroid sides. During a regular follow-up over the period of 12 months at least, we saw 22 transitory pareses of N. recurrens, which corresponds to a reversibility rate of 35%. In first surgical interventions with benignant histology the reversibility rate was 49%. Depending on first or relapse surgery, the histological findings and chosen surgical method the rate of permanent unilateral pareses of N. recurrens was only 1.7% in relation to the first time operated sides of benignant strumata.