FREQUENCY OF RECURRENT LARYNGEAL INJURY IN THYROIDECTOMY SURGERY

Background: Thyroidectomy is one of the most complicated surgeries because of damage to recurrent laryngeal nerve. The objective of the study was to determine the frequency of recurrent laryngeal injury in thyroidectomy surgery. Material Methods: This record based, cross sectional study was conducted in the department of general surgery, Gomal Medical College, D.I.Khan, from 2008 to 2014. Sample size of the study was 104, selected through consecutive sampling technique. Patients who underwent thyroid surgery for thyroid disease were included. Indirect laryngoscopy was performed preoperatively and was repeated postoperatively for all patients. Demographic variables were gender, age in years, age groups. Research variables were type of surgery, technique, type of goiter. Histological diagnosis with dysphonia or vocal cord paralysis greater than 06 months duration was termed as permanent RLN injury while less as temporary injury. Results: Out of total 104 patients 84 (81%) were females and 20 (19%) were male. Indications for surgery were multinodular goiter in 62 cases, solitary nodule in 18, hyperthyroidism in 17, thyroid carcinoma in 2 and recurrent goiter in 5 cases. Bilateral subtotal thyroidectomy was performed in 71 cases (68%), unilateral subtotal thyroidectomy in 13 (12%), unilateral total thyroidectomy in 6 (6%), bilateral total thyroidectomy in 6 (6%), nodule excision in 3 (3%) and completion thyroidectomy for recurrent goiter in 5(5%) cases. Conclusion: Frequency of RLN injury was almost 5% as whole in thyroid surgery but rate was more in complicated cases like thyroid carcinoma, recurrent goiter and hyperthyroid goiter because of altered anatomy.