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Laryngeal Nerves and Voice Change in Thyroid Surgery
R Dayananda Babu1, Deepak Paul1
1Department of General Surgery, Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Trivandrum, Kerala 695607 India.
Indian Journal of Surgical Oncology
|April 25, 2022
Summary
Routine post-operative laryngoscopy reveals higher recurrent laryngeal nerve (RLN) and external branch of superior laryngeal nerve (EBSLN) injury rates during thyroid surgery. One-third of patients experienced voice changes despite normal vocal cord function.
Area of Science:
- Otolaryngology
- Thyroid Surgery
- Nerve Injury
Background:
- Literature often quotes low recurrent laryngeal nerve (RLN) and external branch of superior laryngeal nerve (EBSLN) injury rates.
- These figures are typically based on expert series, potentially underestimating true incidence.
Purpose of the Study:
- To determine the exact incidence of RLN and EBSLN injury in thyroid surgery.
- To evaluate the impact of routine pre-operative and post-operative laryngoscopy on reported nerve injury rates.
Main Methods:
- Implementing routine pre-operative and post-operative laryngoscopy for all thyroid surgery patients.
- Documenting and analyzing nerve identification and any post-operative vocal cord abnormalities.
Main Results:
- Routine post-operative laryngoscopy identified increased rates of RLN and EBSLN injury compared to literature estimates.
- Subjective voice changes were reported in one-third of patients, irrespective of observed vocal cord motion.
Conclusions:
- Routine laryngoscopy is crucial for accurately assessing nerve injury incidence in thyroid surgery.
- Informed consent must explicitly include the risk of voice change, even with normal vocal cord function post-operatively.
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