Postoperative recurrent nerve palsy

During the past seven years, a total of 1,713 patients underwent strumectomy for a variety of causes at the University of Düsseldorf. Unilateral palsies of the recurrent nerve developed in 147 patients. Both vocal cords were paralyzed in 22 patients. Of the 147 patients with unilateral palsies, 53 patients were available for follow-up examination after one year. In 28 of these patients, complete paresis of the vocal cord remained. Twenty-three patients showed complete recovery and normal function of the affected cord. In two patients, reduced but marked mobility of the previously completely paralyzed vocal cord was present. Of the 22 patients with bilateral recurrent nerve palsies, 10 were available for follow-up examination one year later. In three of these patients vocal cord movement was still absent, in three others one vocal cord showed normal function, and in only one patient did both vocal cords reveal normal physiologic mobility. Three other patients demonstrated a reduced but marked mobility of one vocal cord. The results are discussed in relation to the clinical and histologic data.