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Related Experiment Video

Updated: Feb 7, 2026

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

Published on: October 24, 2025

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Does the recurrent laryngeal nerve recover function after initial dysfunction in patients undergoing thyroidectomy?

Gouri Pantvaidya1, Aseem Mishra1, Anuja Deshmukh1

  • 1Department of Head and Neck Surgery Tata Memorial Hospital Mumbai India.

Laryngoscope Investigative Otolaryngology
|August 1, 2018
PubMed
Summary

Most patients with vocal cord palsy after thyroid cancer surgery recover function. Recovery is significant even after repeat surgeries, supporting a watchful waiting approach for mild symptoms.

Keywords:
function recoveryrecurrent laryngeal nervethyroid cancerthyroidectomy

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Area of Science:

  • Endocrinology
  • Otolaryngology
  • Surgical Oncology

Background:

  • Total thyroidectomy is standard for thyroid carcinoma, with potential for recurrent laryngeal nerve (RLN) injury.
  • Vocal cord palsy (VCP) and its recovery after thyroid surgery are not well-documented.
  • Extensive dissection can cause vocal cord dysfunction even without direct nerve sacrifice.

Purpose of the Study:

  • To analyze the incidence of vocal cord palsy (VCP) after thyroid cancer surgery.
  • To determine VCP recovery rates in patients undergoing thyroidectomy.
  • To identify risk factors for permanent VCP.

Main Methods:

  • Retrospective analysis of prospectively collected data from 152 thyroidectomy patients.
  • 254 recurrent laryngeal nerves (RLNs) at risk were assessed.
  • Laryngoscopic examination for vocal cord function, with binary logistic regression for risk factor analysis.

Main Results:

  • The immediate postoperative VCP rate was 11.2% (9% primary, 16.2% redo surgery).
  • Complete VCP recovery occurred in 66.7% of affected nerves.
  • Permanent RLN palsy incidence was 3.9%, with a mean recovery time of 9.6 months.

Conclusions:

  • Vocal cord dysfunction shows good recovery in most patients post-thyroidectomy, including redo surgeries.
  • A conservative approach of watchful waiting is recommended for patients without severe symptoms.
  • The study highlights significant functional recovery potential despite surgical risks.