scholarly journals Evaluation of Total Thyroidectomy for Treatment of Benign Diseases of Thyroid Gland

2020 ◽  
Vol 8 (B) ◽  
pp. 166-170
Author(s):  
Risto Cholancheski ◽  
Natasha Tolevska ◽  
Ardit Qafjani ◽  
Ilir Vela ◽  
Borislav Kondov ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Laryngeal Nerve ◽  
Thyroid Diseases ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Laryngeal Nerve Palsy ◽  
Toxic Goiter ◽  
Benign Thyroid

BACKGROUND: The controversy of using total thyroidectomy (TT) in treatment of benign thyroid diseases still remains controversial over the rates of complication, mostly recurrence nerve palsy and hypocalcemia, compared to non-total thyroidectomies. The latest reports in this field of research showed that that the number of complications of TT is decreasing as the skills of surgeons increase. AIM: In this study, we reviewed 209 cases of total thyroidectomies for benign thyroid diseases where such surgery was indicated. The results were evaluated whether they support the previous reports that TT is save method of treatment of diffuse multinodular goiters, Graves’ disease thyroid adenomas with diffuse goiters and thyroiditis. METHODS: Two hundred and nine patients, 36 males and 173 females, medium age 47 (17–77) operated with TT between 2016 and 2018 were included in the evaluation study. We evaluated the: Diagnosis, indications for operation, pre-operative medication administration, laryngeal recurrent nerve palsy, hypocalcemia, hypoparathyroidism, and patohistology findings. The follow-up for hypocalcemia and laryngeal nerve palsy was performed 1 year postoperatively. RESULTS: The age of the patients was between 17 and 77 years, medium-range 47 years old. Of 209 patients, 173 (83%) were female and 36 (17%) male with a gender ratio of 1:4.8 males to females. Diagnoses before surgery were established as follows: Multinodular euthyroid goiter (MNEG) n = 106 (48.80%), multinodular toxic goiter n = 12 (5.74%), Graves’s disease n = 6 (2.87%), adenoma with multinodular goiter n = 73 (34.92%), and n = 16 (7.65%) patients with thyroiditis. Recurrence laryngeal nerve palsy (RLNP) occurred in 6 patients (2.87%), temporary within 3 months after the operation in 4 patients (1.92%) and permanent palsy within 6 months and more after an operation in 2 patients (0.95%). Voice hoarseness immediately and within 1 month after the operation was registered in 32 patients (15.3%). RLNP and hoarseness were registered mostly in patients with pre-operative problems, mostly with extra big MNEG. One of the permanent injuries of RLN was bilateral and all others were one sided. All patients were operated with normal pre-operative vocal cord movement findings. Post-operative hypocalcemia was registered in 35 patients (16.74%). Temporary nonsignificant hypocalcemia in 10 (4.78%), temporary significant hypocalcemia in 17 (8.13%), temporary severe hypocalcemia in 6 patients (2.87%), and permanent hypocalcemia in 2 patients (0.95%). CONCLUSION: Many studies have shown that the rate of complications is almost even for TT and NTT done for benign and malignant diseases of thyroid gland. Our data have shown that the risk of post-operative complications with TT is proportional to the number of complicated pre-operative findings of benign thyroid glands.

scholarly journals Surgery of the Thyroid Gland

1997 ◽  
Vol 40 (3) ◽  
pp. 71-74
Author(s):  
Jan Vokurka ◽  
Stanislava Jakoubková ◽  
Jaroslav Růžička
Keyword(s):  
Thyroid Gland ◽  
Surgical Technique ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Diagnostic Procedure ◽  
Postoperative Bleeding ◽  
Blood Transfusions ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Laryngeal Recurrent Nerve

Since the year 1987 to 1996 all kinds of thyroid surgeries were performed at the ENT Department. Altogether 604 patients underwent 655 surgeries. Total lobectomy or total thyroidectomy represented the most common procedures. Due to a gentle surgical technique, which we call ãpreparationÒ, good results were achieved in the morbidity of laryngeal recurrent nerve (permanent palsy in 0.6%), and in perioperative or postoperative bleeding (0.3% of wound revisions, 0.5% of blood transfusions). Postoperative hypoparythyroidism was found in 4.7% patients. There is no correlation between postoperative hoarseness and laryngeal recurrent nerve palsy. Laryngeal endoscopy immediately after surgery is the most valuable diagnostic procedure.

Recurrent nerve palsy and hypocalcemia after surgery of benign thyroid diseases

1996 ◽  
Vol 28 (6) ◽  
pp. 361-363 ◽  
Author(s):  
J. Witte ◽  
D. Simon ◽  
Cornelia Dotzenrath ◽  
J. Sensfuß ◽  
P. E. Goretzki ◽  
...  
Keyword(s):  
Nerve Palsy ◽  
Thyroid Diseases ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Benign Thyroid

Recurrent laryngeal nerve palsy during surgery for benign thyroid diseases: Risk factors and outcome analysis

Surgery ◽  
2014 ◽  
Vol 155 (3) ◽  
pp. 522-528 ◽  
Author(s):  
Keisuke Enomoto ◽  
Shinya Uchino ◽  
Shin Watanabe ◽  
Yukie Enomoto ◽  
Shiro Noguchi
Keyword(s):  
Risk Factors ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Thyroid Diseases ◽  
Outcome Analysis ◽  
Laryngeal Nerve Palsy ◽  
Benign Thyroid

Recurrent laryngeal nerve palsy secondary to benign thyroid disease

1994 ◽  
Vol 108 (10) ◽  
pp. 878-880 ◽  
Author(s):  
J. E. Fenton ◽  
C. I. Timon ◽  
D. P. McShane
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Thyroid Disease ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Recurrent Nerve ◽  
Benign Thyroid Disease ◽  
Nerve Paralysis ◽  
Benign Thyroid

Abstract: A recurrent nerve palsy occurring in the presence of a goitre is considered to be caused by thyroid malignancy until proven otherwise.Three cases are described in which benign thyroid disease resulted in recurrent laryngeal nerve paralysis. Recent haemorrhage was implicated histologically as the possible aetiology in all three cases. The importance of identifying and preserving the recurrent laryngeal nerve in the surgical management is highlighted.

Importance of Identifying the Course of the Recurrent Laryngeal Nerve in Total and Near-Total Thyroid Lobectomies

2005 ◽  
Vol 71 (3) ◽  
pp. 225-227
Author(s):  
Zeki Acun ◽  
Fikret Cinar ◽  
Alper Cihan ◽  
Suat Can Ulukent ◽  
Lokman Uzun ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Injury ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Thyroid Diseases ◽  
Thyroid Lobectomy ◽  
Laryngeal Nerve Injury

In our clinic, near-total thyroidectomy is the principal surgical procedure performed for benign thyroid diseases. We conducted a single-institution study on 176 consecutive patients who underwent near-total thyroidectomy due to various thyroid diseases. We compared the incidence of recurrent laryngeal nerve injury between total and near-total thyroid lobectomy sides in each patient. Our hypothesis was that the incidence of recurrent laryngeal nerve injury after total thyroid lobectomy would be similar to that of near-total thyroid lobectomy when the course of the recurrent laryngeal nerve was identified during surgery. The temporary recurrent laryngeal nerve palsy rates on the total and near-total thyroid lobectomy sides were 3.9 per cent (7 of 176 nerves) and 2.2 per cent (4 of 176 nerves), respectively. The difference was not statistically significant. Permanent recurrent laryngeal nerve palsy did not occur in any of our patients. In conclusion, the incidence of recurrent laryngeal nerve injury in total versus near-total thyroid lobectomy is not different when the course of the recurrent laryngeal nerve is identified during surgery.

Total thyroidectomy for safe and definitive management of Graves' disease

2013 ◽  
Vol 127 (7) ◽  
pp. 681-684 ◽  
Author(s):  
A Prasai ◽  
P A Nix ◽  
M Aye ◽  
S Atkin ◽  
R J England
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Definitive Treatment ◽  
Royal Infirmary ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy

AbstractBackground:The role of total thyroidectomy in the management of patients with Graves' disease remains controversial. However, there is increasing evidence to support the role of the procedure as a safe and definitive treatment for Graves' disease.Method:Patients were identified from a prospective thyroid database of the multidisciplinary thyroid clinic at Hull Royal Infirmary. All case notes were independently reviewed to confirm the data held on the database.Results:Over a 7-year period, the senior author has performed 206 total thyroidectomies for Graves' disease. The incidence of temporary recurrent laryngeal nerve palsy and hypoparathyroidism was 3.4 per cent and 24 per cent respectively. There was one case of permanent unilateral recurrent laryngeal nerve palsy, and 3.9 per cent of patients developed permanent hypoparathyroidism. There has been no relapse of thyrotoxicosis.Conclusion:In the context of a multidisciplinary thyroid clinic, total thyroidectomy should be offered as a safe and effective first-line treatment option for Graves' disease.

scholarly journals Delayed recurrent nerve paralysis following post-traumatic aortic pseudoaneurysm

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 215-219 ◽  
Author(s):  
Massimo Mesolella ◽  
Filippo Ricciardiello ◽  
Domenico Tafuri ◽  
Roberto Varriale ◽  
Domenico Testa
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Motor Vehicle ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Recurrent Nerve ◽  
Nerve Paralysis ◽  
Aortic Pseudoaneurysm ◽  
Laryngeal Nerve Palsy ◽  
Post Traumatic

AbstractBlunt trauma to the neck or to the chest are increasingly observed in the emergency clinical practice. They usually follow motor vehicle accidents or may be work or sports related. A wide pattern of clinical presentation can be potentially encountered. We report the uncommon case of a patient who was referred to our observation presenting with hoarseness and disphagia. Twenty days before he had sustained a car accident with trauma to the chest, neck and the mandible. Laryngoscopy showed a left recurrent laryngeal nerve palsy. Further otolaryngo-logical examination showed no other abnormality. At CT and MR imaging a post-traumatic aortic pseudoaneurysm was revealed. The aortic pseudoaneurysm was consequently repaired by implantation of an endovascular stent graft under local anesthesia. The patient was discharged 10 days later. At 30-days follow-up laryngoscopy the left vocal cord palsy was completely resolved.Hoarseness associated with a dilated left atrium in a patient with mitral valve stenosis was initially described by Ortner more than a century ago. Since then several non malignant, cardiovascular, intrathoracic disease that results in embarrassment from recurrent laryngeal nerve palsy usually by stretching, pulling or compression; thus, the correlations of these pathologies was termed as cardiovocal syndrome or Ortner’s syndrome. The reported case illustrates that life-threatening cardiovascular comorbidities can cause hoarseness and that an impaired recurrent laryngeal nerve might be correctable.

Value of intra-operative neuromonitoring of the recurrent laryngeal nerve in total thyroidectomy for benign goitre

2015 ◽  
Vol 129 (6) ◽  
pp. 553-557 ◽  
Author(s):  
C Page ◽  
P Cuvelier ◽  
A Biet ◽  
V Strunski
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Control Group ◽  
Laryngeal Nerve Palsy ◽  
Significant Difference ◽  
Patient Groups ◽  
The Impact

AbstractObjective:This study aimed to evaluate the impact of intra-operative neuromonitoring of the recurrent laryngeal nerve during total thyroidectomy for benign goitre.Methods:A single-centre retrospective study using historical controls was conducted for a 10-year period, comprising a series of 767 patients treated by total thyroidectomy for benign goitre. Of these, 306 had intra-operative neuromonitoring of the recurrent laryngeal nerve and 461 did not. Post-operative laryngeal mobility was assessed in all patients by direct laryngoscopy before hospital discharge and at post-operative follow-up visits.Results:In all, 6 out of 461 patients (1.30 per cent) in the control group and 6 out of 306 patients (1.96 per cent) in the intra-operative neuromonitoring group developed permanent recurrent laryngeal nerve palsy. No statistically significant difference was observed between the two patient groups.Conclusion:Intra-operative neuromonitoring does not appear to affect the post-operative recurrent laryngeal nerve palsy rate or to reliably predict post-operative recurrent laryngeal nerve palsy. However, it can accurately predict good nerve function after thyroidectomy.

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