ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
Factors Effecting Recurrent Laryngealnerve Injury After Thyroİd Gland Surgery
Mutlu Doğanay*, Ramazan Mahanoğlu*, Nuri Aydın Kama*,
Erhan REİS*, Uğur Gözalan*, Ercan KESİCİ*
*Dr.,Ankara Numune Eğitim ve Araştırma Hastanesi 4. Cerrahi Kliniği, ANKARA
Thyroid surgery requires special knowledge, ability and experience because of thyroid gland’s relationship with vital organs. Protection of recurrent laryngeal nerve is the most important part of thyroidectomy operations. In this study we investigated recurrent laryngeal nerve (RLN) injuries after thyroidectomy operations done in our clinic, and factors that affect this.
In our study we investigated 465 patients who had thyroidectomy between January 1990 and October 1996 and October 1996 and were followed for at least 12 months to 67 months. Sex age, clinical diagnosis, experience of the operation team, observation of RLN nerve, type of operation and duration of the operation were assesed for their effect on paralysis of the vocal cord. Chi-square or Fisher's exact test were used for univariety analysis, and multiple logistic regression test was used for multivariety analysis.
412 (88.6%) of the 465 patiens were female, and 53 of them (11.6%) were male. Mean age was 37.7. Fifty-seven patients had vocal cord paralysis. 45 (9.7%) of these were temporary. 12 (2.5%) were permanent and the rate of healing was 78.9%. It was found 2.5% according to patients who had permanent nerve paralysis, and 1.3% according to RASS. The rate of permanent vocal cord paralysis according to the number of patients was 2.5% in benign thyroid diseases and 4.7% in thyroid cancer and the difference was statistically significant (p<0.0001). This ratio was 20% in recurrent goitre operations and the increase of nerve injury was statistically significant (p<0.05). According to RASS in patients who had total thyroidectomy permanent nerve injury was 5.4% and 1.1 % in patients who had subtotal thyroidectomy and the difference was statistically significant (p<0.01). In cases where the operations have lasted longer than 90 minutes the increase of nerve injury was statistically significant (p<0.005). The effect of the operation teams’ experience and whether the nerve was observed or not on the recurrent laringeal nerve injury was not statistically significant.
Thyroid carcinoma, recurrent goitre, total thyroidectomy operation, duration of the operation are factors which increase the risk of postoperative RLN injury. Experience, being obscessive and careful are the most important factors that decrease this risk.Keywords: Thyroidectomy, recurrent laryngeal nerve injuryTurkiye Klinikleri J Med Sci 1999, 19:193-199
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