Recurrent laryngeal nerve paralysis contralateral to hemithyroidectomy. Case report

Area of Science:

• Otolaryngology
• Neurology
• Surgical Complications

Background:

• Recurrent laryngeal nerve (RLN) injury is a known complication of thyroid surgery.
• Hemithyroidectomy, while less extensive than total thyroidectomy, still carries a risk of nerve damage.
• Transient paralysis of the RLN contralateral to the surgical site is an uncommon presentation.

Observation:

• Two distinct cases of hemithyroidectomy are presented.
• Both patients experienced temporary paralysis of the recurrent laryngeal nerve on the side opposite the thyroid lobe removed.
• The paralysis resolved spontaneously in both instances.

Findings:

• The study reviews existing literature on contralateral recurrent laryngeal nerve paralysis post-thyroidectomy.
• Potential etiologies, including neural manipulation, vascular compromise, and inflammatory responses, are explored.
• The contralateral nature of the paralysis suggests mechanisms beyond direct surgical trauma.

Implications:

• Understanding the pathophysiology of this rare complication is crucial for accurate diagnosis and patient counseling.
• Awareness among surgeons may lead to modified surgical techniques or enhanced monitoring.
• Further research is needed to elucidate the precise mechanisms and optimize preventative strategies for this specific nerve injury.