Abstract
Recurrent Laryngeal Nerve palsy following thyroidectomy is usually attributed to surgery whereas sometimes the cause can be non-surgical and can result in adductor palsy. Bilateral Recurrent Laryngeal Nerve paralysis is a rare complication of thyroidectomy. We present a case of a 35 years old female who developed dysphonia following thyroidectomy. The clinical findings and recovery were suggestive of a non-surgical cause for palsy. The management of these patients differs and the knowledge in this regard is very important for the surgeons. The non-surgical and surgical cause of adductor palsy differs in presentation and management. Tracheostomy is not required, and recovery of the nerve occurs in most cases. Keywords: palsy; recurrent laryngeal nerve; total thyroidectomy.
Highlights
Bilateral Recurrent Laryngeal Nerve (RLN) paralysis is an uncommon complication of thyroidectomy, the commonest surgery that puts normally functioning laryngeal nerves at risk of injury.[1,2]
Recent study showed that the likelihood of temporary RLN paralysis is higher in bilateral near total thyroidectomy compared to bilateral total thyroidectomy.[3]
Bilateral RLN paralysis is a major risk factor for dysphonia, airway obstruction and is significantly associated with post- thyroidectomy vocal cord paralysis and long term risks of hospital readmission, dysphagia, hospitalization for lower respiratory tract infection and tracheostomy/gastrostomy
Summary
Bilateral Recurrent Laryngeal Nerve (RLN) paralysis is an uncommon complication of thyroidectomy (seen in 0.4%), the commonest surgery that puts normally functioning laryngeal nerves at risk of injury.[1,2] Injury to the RLN could be temporary or permanent, unilateral or bilateral. Thyroid function test and serum calcium levels were within normal range.
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