No5-6(3) 2020
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DOI 10.37219/2528-8253-2020-6-34 |
Solomennikova NV, Palamarchuk VO, Deeva YuV, Savchenko TD
Recurrent laryngeal nerve injury after thyroid surgery |
Solomennikova Natalya V.
Consultative Otorhinolaryngologist, O.O. Bogomolets National Medical
University, Kyiv. Kyiv
E-mail: solomennikova@ukr.net
ORCID: http://orcid.org/ 0000-0001-9920-8861
Palamarchuk Volodymyr O.
MD, PhD, Head of the Department of Endocrine Surgery, Ukrainian Scientific
and Practical Center for Endocrine Surgery, transplantation of endocrine
organs and tissues, Ukrainian Ministry of Healthcare
E-mail: paldoc@i.ua
ORCID: http://orcid.org/ 0000-0001-9554-4817
Dieeva Julia V.
MD, PhD, professor, head of the department of Otorhinolaryngology O.O.
Bogomolets, Kiev
E-mail: deyeva@bigmir.net
Savchenko Tamila D.
Candidate of Medical Sciences, collaborator of the department of ENT
diseases of ENT organ diseases of "O.S. Kolomiychenko Institute of
Otolaryngology NAMS Ukraine", Kyiv
E-mail: tamilads@ukr.net
ORCID: http://orcid.org/0000-0001-5550-5530 |
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Abstract
Relevance: Thyroid surgery is dangerous and can lead to damage RLN.
The frequency of nerve damage varies widely and this is due to the fact that
not always immediately after surgery and subsequent examination of the
larynx. This leads to late start of treatment.
Purpose of this research is estimate the frequency of transient and
permanent immobility of the vocal folds
after thуroid surgery.
Materials and methods: It was prospective cohort monocenters
investigate. 1364 patients were examined. We developed “voice passport of
the patient” to improve the diagnosis and treatment. It included data of
examination and treatment. All patients in the preoperative and
postoperative periods were examination: laryngoscopy, laryngeal
videoendoscopy, voice spectral analysis and Voice Handicap Index (VHI-30
modified version) by Jacobcon.
Results and discussion: Postoperative disorders of motion vocal folds
were in 132 (9.7%) patients. Recovery of motion vocal folds were observed in
123 patients, which were 93.2% of the total number of cases of damage RLN
(132) and 9.1% of the total number of surgical interventions (1364). Lack of
recovery of motion vocal folds more than one year (laryngeal paralysis) was
observed in 9 patients, which was 6,8% of the total number of cases of
damage RLN (132) and 0.6% of the total number of surgical interventions
(1364).
Conclusions: Studying the frequency of paresis and paralysis of the
larynx depending on the type of surgery and predicting the risks of PGN
depending on the scope of the intervention before its implementation allows
to reduce the number of postoperative complications and optimize management
tactics in cases where nerve injury can’t be avoided. |
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Keywords
thyroid cancer, parathyroid cancer, recurrent laryngeal nerve, vocal fold,
laryngeal paresis, laryngeal paralysis. |
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