Recurrent laryngeal nerve palsy in thyroid gland surgery related to operations and nerves at risk
H. Martensson and J. Terins
Recurrent laryngeal nerve palsy is rare, but it is the most common
complication in thyroid gland surgery. Depending on whether the measurement
of the rate of occurrence is based on the number of operations or on the
number of nerves at risk, the rate may vary widely. The elapsed time from
the operation to when the palsy is considered permanent has also differed
among various studies. In a ten-year series of 514 thyroid gland operations
at a county hospital, all patients with a postoperative palsy were examined
six months to ten years after the operation. After a primary operation
almost 50% of the palsies were temporary, reducing the permanent palsy rate
to 5.8% based on the number of operations, or 3.6% based on the number of
nerves at risk. With more extensive surgery, the rate increased. This
series illustrates the importance of the method by which the recurrent
laryngeal nerve palsy rate is defined and calculated. The rates also show
that the complication rate may be kept at a low level even in a
nonspecialized unit.
