COMPARISON OF RECURRENT LARYNGEAL NERVE (RLN) PALSY WITH AND WITHOUT INTRAOPERATIVE NERVE IDENTIFICATION DURING THYROIDECTOMY – A CROSS-SECTIONAL STUDY FROM A TERTIARY LEVEL HOSPITAL IN PESHAWAR

Abstract

Background:Recurrent laryngeal nerve (RLN) palsy is one of the most common and feared complications of thyroid surgeries. These may be transient or permanent and occur unilaterally or bilaterally, in case of which fatal airway obstruction is possible.
 Objectives:To compare the incidence of RLN palsy with and without intraoperative nerve identification during thyroidectomy.
 Materials and Methods: This is a descriptive cross-sectional study spanning over 9 months during the period July 2020 to March 2021. A pool of 70 patients was included in the study comprising of 18 males and 52 females. Data on demographic, clinical and postoperative variables were compared in relation to RLN palsy.
 Results:The overall incidence of RLN palsy in the study pool was 7.1%. The rate of RLN palsy was 3.51% in the 81.42% cases where intraoperative nerve identification was done and 13.04% incidence was found the remaining 32.86% cases where the nerve was not identified. The incidence of RLN palsy was 14.82% in ages above 45 years, 11.11% in male, 14.29% after total thyroidectomy and 40% with follicular carcinoma.
 Conclusion:Intraoperative nerve identification is an essential step in any thyroid surgery and has proven beneficial in reducing the incidence of RLN palsy.