Gul Zarin Khan, Farogh Zahra, Imtiaz Hussain, Nisar Ahmad Khan, Amir Zaman Khan.
Frequency and Factors Leading to Recurrent Laryngeal Nerve (RLN) Injury during Thyroid Surgery.
J Fatima Jinnah Med Coll Lahore Jan ;8(2):14-8.

Objectives: The objectives of this study were to determine the frequency and to assess the factors leading to Recurrent Laryngeal Nerve (RLN) injury during thyroid surgery at a tertiary care hospital. Study Design: Descriptive case series. Setting: Surgical Unit-I, Fatima Jinnah Medical College/Sir Ganga Ram Hospital, Lahore. Subject and Methods: Four hundreds and seventy patients were included in this study. Patients with preexisting RLN injury and those with concomitant parathyroid pathology were excluded from the study. RLN injury was documented by post-operative finding of absent vocal cord movement on direct laryngoscopy by the anesthetist at the time of extubation. Results: The mean age of the patients was 45.33±10.20 years and 71.9% were female. Total thyroidectomy was the most common (43%) surgical procedure performed. Fifty nine (12.6%) patients underwent redo surgery and in 61 (13%) patients histopathology report revealed malignant lesion. RLN injury was noted in 18 (3.8%) cases of the total surgeries. The occurrence of RLN injury was significantly higher among Total Thyroidectomy patients (7.4%, p=.006) and those with malignant thyroid lesion (13.1% vs. 2.4%, p=.000). However, there was only insignificant difference between redo and primary surgery (3.9% vs. 3.4%; p=.851). Conclusion: RLN injury is a frequent complication of thyroid surgery and the occurrence is even higher among patients undergoing total thyroidectomy, redo surgery and those with malignant thyroid lesion.

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