Protection of the recurrent laryngeal nerve and the superior laryngeal nerve in the thyroidectomy

Objective To investigate how to correctly protect the recurrent laryngeal nerve (RLN) and the superior laryngeal nerve(SLN) in the thyroidectomy, to avoid and reduce permanent neurologic injury postoperation. Methods One hundred and forty-one cases who underwent thyroidectomy (37 male, 104 female, aged 9-78) were retrospectively analyzed from June 2013 to Nov. 2014 in Nanjing Tongren Hospital, including total thyroidwctomy(54 patiens), lobectomy(58 patiens), thyroid lobectomy with contralateral partial thyroidectomy (29 patiens), among them, 10 cases of secondary surgery, and Ⅵ area lymph nodes cleaning 18 patiens. Intraoperative RLN revealed 121 patiens, 20 patients did not show. Results All 141 patients were successfully completed surgery. The RLN transitory injury was occurred in 5 sides (2.56%, 5/195), All the nerve function recover within 3 months postoperation after hormones, nurotrophic drug therapy, and cooperate with the pronunciation training. There were no RLN permanent damage and the SLN injury. Conclusions The permanent damage of nerve can be prevented by being familiar with anatomic variation of the RLN, SLN and thyroid, meticulous operation with membrane dissection technology. In the event of nerve damage, a timely manner to give symptomatic treatment can improve the patient`s quality of life. Key words: Thyroidectomy; Intraoperative complication; Vivisection; Recurrent laryngeal nerve injury; Superior laryngeal nerve injury