Prevention and treatment of recurrent laryngeal nerve injury during thyroid operation

Objective To evaluate the necessity of dissect the recurrent laryngeal nerve in operation of thyroid gland.Methods From March 2001 to Mar 2010,there were 512 patients in our hospital who underwent operation of thyroid gland,and they were divided into two groups according to whether or not the recurrent laryngeal nerve was dissected during the operation.The rate of injury of recurrent laryngeal nerve between the two group was compared.Results Among the 32 cases in dissection of recurrent laryngeal nerve group,3 cases(9.3%)had hoarseness after operation,and in the 323 cases without dissection of the recurrent laryngeal nerve group,5 cases(15.6%)had hoarseness after operation,but the difference was not significant.Howere,in the high risk cases between the two groups,the different was significant.Conclusion Whether or not dissect the recurrent laryngeal nerve should be decided by the specific circumstances.For most benign lesions,one should,if possible,not expose the recurrent laryngeal nerve,but for large thyroid neoplasms,second or multiple operations and thyroid cancer,exposure of recurrent laryngeal nerve is necessary.