[Safe thyroidectomy for thyroid and parathyroid diseases]

Area of Science:

• Surgical Oncology
• Otolaryngology
• Endocrinology

Background:

• Thyroidectomy is a common procedure for thyroid and parathyroid diseases.
• Damage to the recurrent laryngeal nerve (RLN) during thyroidectomy can lead to significant postoperative complications, primarily phonation disorders.
• Variability in RLN topography necessitates careful surgical planning and execution.

Purpose of the Study:

• To present a safe thyroidectomy technique focused on preventing recurrent laryngeal nerve damage.
• To evaluate the efficacy of a specific surgical approach in minimizing RLN injury.

Main Methods:

• Analysis of postoperative outcomes in 342 patients undergoing thyroidectomy.
• Anatomical study of RLN topography on 20 laryngeal-tracheal complexes.
• Development and application of a visualization and mobilization technique for the RLN.

Main Results:

• The study identified variable RLN locations in patients with nodular goiter, retrosternal goiter, and parathyroid adenoma.
• Visualization and mobilization of the RLN were confirmed as crucial for preventing intraoperative damage.
• Implementation of the described technique and training reduced phonation disorder incidence from 21.6% to 0.98%.

Conclusions:

• Thyroidectomy can be performed safely with meticulous attention to surgical technique and anatomical structures.
• Routine visualization and mobilization of the recurrent laryngeal nerve are essential for preventing postoperative voice dysfunction.
• This approach enhances patient safety and improves outcomes in thyroid and parathyroid surgery.