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Management of unilateral recurrent laryngeal nerve injury after thyroid surgery: A review
Author(s) -
Lynch Jeremy,
Parameswaran Rajeev
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24772
Subject(s) - medicine , recurrent laryngeal nerve , iatrogenic injury , nerve injury , spinal cord injury , thyroid , reinnervation , surgery , thyroid cartilage , laryngoplasty , anesthesia , larynx , spinal cord , psychiatry
Background Recurrent laryngeal nerve (RLN) damage because of thyroid and parathyroid surgery has been recognized for over a century. Injury rates have been slowly decreasing in this period while effective treatment strategies have been increasing. Methods Recent literature was evaluated on the topics of anatomy, pathophysiology, avoidance, and conservative and surgical treatment of RLN injury. Data for this literature review were identified by PubMed and references from relevant articles using the search terms “thyroid,” “laryngeal nerve,” and “injury.” Only articles published in English between 1990 and 2015 were included. Results Advances in technique and equipment have made injury less likely. The evidence and role for neuromonitoring is discussed. Treatment strategies may include speech therapy, vocal cord augmentation using injection, laryngeal framework surgery techniques (including laryngoplasty and arytenoid adduction), and reinnervation. Conclusion Injury rates in specialist centers are very low. Good to excellent results may be obtained in most cases.