Recurrent nerve injury after goiter surgery

: During a period of five years, 230 patients were treated operatively on account of benign thyroid disease. The present investigation is particularly directed towards the frequency of transient/permanent and unilateral/bilateral pareses of the vocal cords resulting from lesion of the recurrent nerve during surgical intervention on the thyroid gland. The material consists of 199 women and 31 men. The average age for the entire material was 46 years. Seventy-one patients had been submitted to unilateral intervention and in 159 the intervention was bilateral. Indirect laryngoscopy was carried out on all of the patients before and after operation. The operations were carried out by surgeons-in-charge, registrars, trainee registrars and experienced house surgeons. Transient unilateral pareses developed postoperatively in 17 patients and transient bilateral pareses in five patients. Five patients had permanent unilateral pareses and one patient had permanent bilateral paresis, corresponding to frequencies of pareses of 2.6% and 0.4%. Two patients became chronic tracheostomy cases. Intensive control of vocal cord function and the importance of laryngoscopy are emphasized. The question of the ideal placing of thyroid surgery as regards training and the departments concerned is discussed.