The prevention and management of recurrent laryngeal nerve injury during thyroidectomy

Objective To discuss the strategies in avoiding recurrent laryngeal nerve(RLN) injury during thyroidectomy. Methods The clinical data of 539 cases of thyroidectomies were retrospectively analyzed. Of these, 19 patients experienced RLN injury. The relationship between RLN injury occurrence and total or subtotal thyroidectomy, exposing or not the RLN were studied. The therapeutic efficacy of immediate reparation after the nerve was found cut was evaluated. Results The rate of RLN injury while routine exposition was carried out or not during total thyroidectomy was 3.5% and 19.3%, respectively. The rate of RLN injury was higher in total thyroidectomy than that in subtotal thyroidectomy. Immediate RLN reparation was an effective measure to be taken when the nerve was found cut. Conclusion Exposing the RLN routinely during total thyroidectomy is a reasonable step to be taken, it makes RLN injury be discovered immediately and reparation be done.