Importance of recurrent laryngeal nerve dissection in surgery for benign thyroid diseases

Abstract:

Objective: To assess the value of laryngeal recurrent nerve (RLN) dissection during primary surgery for benign thyroid diseases.
Methods: Two hundred and forty-one patients with benign thyroid disease who underwent surgery performed by the same surgeon were retrospectively analyzed. Of the patients， 159 cases had unilateral total lobectomy and 82 cases had bilateral total lobectomy. The patients were divided into dissection group (145 cases) and non-dissection group (96 cases) as to whether or not they had RLN dissection. The incidences of RLN injury of the two groups were counted according to the number of RLN at risk of injury during surgery， and the difference in temporary and permanent RLN injury rates between the two groups was analyzed.
Results: The incidence rate of temporary and permanent RLN injury was 4.1% and 0 in the dissection group， and was 5.4 and 3.8% in the non-dissection group， respectively. The incidence rate of temporary RLN injury had no statistical difference between the two groups (P＞0.05). The incidence rate of permanent RLN injury of the dissection group was lower than that of the non-dissection group， and this had statistical difference (P＜0.05).
Conclusions: RLN dissection during the operation for benign thyroid disease can reduce the risk of permanent RLN injury. Total lobectomy with routine RLN dissection is recommended as a basic procedure in surgery for benign thyroid diseases.