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Recurrent Laryngeal Nerve Palsy and Hypoparathyroidism Related to the Extent of Thyroid Surgery

Aim: The puspose of this study was to evaluate the incidence of recurrent laryngeal nerve palsy (RLNP) and hypoparathyroidism as most common complications associated with thyroid surgery in relation to the extent of the surgical procedure. Patients and Methods: Postoperative data from 426 patients was collected at the Clinical Institute of Nuclear Medicine and Radiation Protection of the Clinical Hospital Centre Osijek. The patients were operated on the Clinic for Otorhinolaryngology and Head and Neck Surgery and Clinical Department of Thoracic Surgery, Department of Surgery, in the period from 2007 to 2009. Postoperative complications after total thyoidectomy with or without neck dissection, near-total and subtotal thyroidectomy and lobectomy with or without isthmectomy were analyzed with multivariate logistic regression. Results: Patient were aged 52±14.9 years (mean±SD), 365 of them female and 61 male (female:male, 5.98:1). Transient RLNP occurred in 19 cases (4.5%) and permanent RLNP in 13 cases (3%). Transient hypoparathyroidism occurred in almost 4% of cases and permanent hypoparathyroidism in 1.4%. The extent of the operative procedure is not significantly associated with the risk for transient or permanent RLNP. In comparison with lobectomy, subtotal/near-total thyroidectomy, but not total thyroidectomy, is associated with a higher risk for RLNP (OR=2.84). Total and subtotal/near-total thyroidectomy carry a higher risk for hypoparathyroidism in relation to lobectomy. Age and gender are no risk factors for postoperative complications. Conclusion: Complications to thyroid surgery are not uncommon. Total thyroidectomy is a good surgical treatment for some thyroid diseases like cancer or severe hyperfunction due to the risk for disease relapse and possible complications of following reoperation.

Thyroid Surgery ; Laryngeal Nerve Palsy ; Hypoparathyroidism

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