April - June 2019

Importance of routine identification of recurrent laryngeal nerve in Hemithyroidectomy

Ruta K. Sayani 1, Urvashi M. Gohil 2

1 Assistant Professor at SMSmultispeciality hospital, Dr. M.K.Shah MCRC, ENT department, Ahmedabad Gujarat
2 ENT surgeon at district hospital Kheda.Gujarat


BACKGROUND AND OBJECTIVES: The aim of this study is to identify the importance of routine dissection of recurrent laryngeal nerve during hemithyroidectomy for preventing injury to the recurrent laryngeal nerve. MATERIAL AND METHOD: It is a retrospective study of 50 patients of hemithyroidectomy operated at SMS multispeciality hospital in ENT department from June 2017 to August 2018. Zuckerkandl’s tubercle was used as a landmark for identification of the nerve. RESULT: Out of 50 patients, recurrent laryngeal nerve was identified in 30 cases. Of the 30 cases, 1 patient developed unilateral recurrent laryngeal nerve palsy in the immediate post-operative period.Of remaining 20 cases in which recurrent laryngeal nerve could not be identified, 3 patients developed palsy in the immediate post-operative period. CONCLUSION: Dissecting the recurrent laryngeal nerve during thyroid surgery can effectively prevent nerve injury during hemithyroidectomy. Zuckerkandl’s tubercle serves as an important landmark in identification of the nerve. There is significant reduction in the rate of recurrent laryngeal nerve palsy if it is identified and preserved during hemithyroidectomy.

Keywords: Recurrent laryngeal nerve, Hemithyroidectomy, Zuckerkandl’s tubercle

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