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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
Recurrent laryngeal nerve paralysis: a complication of thyroidectomy
1Department of Otolaryngology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
The Journal of Otolaryngology
|January 24, 1998
Summary
Malignancy identified during thyroidectomy significantly increases the risk of recurrent laryngeal nerve (RLN) paralysis. Careful surgical technique is crucial, especially in these cases, to prevent nerve injury.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Neurosurgery
Background:
- Recurrent laryngeal nerve (RLN) paralysis is a significant complication following thyroidectomy.
- Understanding factors contributing to RLN injury is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the relationship between surgical factors and recurrent laryngeal nerve (RLN) paralysis after thyroidectomy.
- To identify risk factors associated with temporary and permanent RLN paralysis.
Main Methods:
- Retrospective analysis of 361 thyroidectomy patient records.
- Evaluation of RLN paralysis in relation to surgery type, RLN identification, and histopathology.
- Analysis based on the number of RLNs at risk during surgery.
Main Results:
- The incidence of permanent RLN paralysis was 2.38%.
- Histopathologic findings of malignancy were significantly associated with both temporary and permanent RLN paralysis (p < .005).
- RLN identification and surgery type did not show a significant association with RLN paralysis.
Conclusions:
- Evidence is insufficient to confirm that RLN identification alone reduces paralysis risk.
- Identifying RLNs is essential to prevent iatrogenic injury.
- Meticulous surgical technique is recommended for patients with suspected malignancy due to increased surgical complexity and paralysis risk.
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