Damage to Recurrent Laryngeal Nerve (RLN) with and without Exposure in Thyroidectomy

Abstract

Objectives: To determine damage of RLN with and without exposure during thyroidectomy. Study design: Randomized control study Sampling technique: Non-probability consecutive sampling. Sample size: 150 patients.   Setting: Surgical units of Allied Hospital Faisalabad. Methodology: With informed consent, study was conducted on two groups(75 in each group).Patients were distributed on alternate basis into group A & group B for thyroidectomy with and without identification of RLN respectively. Results: In group A 30(40%) patients were between 31-40 Years & 18(24%) between 41-50 Years. In group B 32(42.7%) were between 31-40 Years,13(17.3%) between 41-50 Years & 15(20%) between 50-60 Years. Mean of age was 38.5 ± 10.9(standard deviation).In group A,28(37.3%) were male and 47(62.7%) females while in group B 25(33.3%) were males and 50 (66.7%) females. In group A 38(50.7%) patients were of MNG, 10 (13.3%) diffuse goiter, 7(9.3) solitary nodules, 13 (17.3%) suspicion of malignancy & 7(9.3%) malignanacy. In group B 33(44%) patients were having MNG, 15(20%) diffuse goiter, 10(13.3%) solitary nodule, 6(8%) suspicion of malignancy & 11(14.7%) malignant disease. In group A 39(52%) patients underwent STT, 20(26.7%) NTT, 10(13.3%) TT and 6(8%) hemi-thyroidectomy. In group B 35(46.7%) patients underwent STT, 21(28%) NTT, 12(16%) TT and 7 (9.3%) hemi-thyroidectomy. In group A 3 (4%) patients developed transient paralysis & 1(1.3%)   permanent paralysis of RLN. In group B 7(9.3%) patients developed transient paralysis & 3(4%) permanent paralysis of RLN. Conclusion: Preservation of RLN is more likely with exposure and identification of RLN post-operatively.