Short term Outcomes of Routine Exposure Versus non Exposure of the Recurrent Laryngeal Nerve During Thyroidectomy for Benign Thyroid Diseases.

Abstract

To evaluate the outcomes of the exposure versus non-exposure of the RLN during thyroidectomy for benign thyroid diseases. A prospective study for patients who underwent thyroidectomy for benign diseases. They were classified into two groups, group 1 (the exposed group) and group 2 (the non-exposed group) of the RLN. History, examination, laboratory and radiological investigations as well as intra and post-operative details were recorded. 97 patients were included in the study, group 1 (63 patients) while group 2 (34 patients). The median age of both groups was 40 (for group 1) and 42 (for group 2) respectively. There was no significant difference regarding the gender of the patients (P = 0.089) and the type of surgery (P = 0.234). The duration of surgery as well as the amount of intraoperative blood loss were equal with no significant difference (P = 0.791) (P = 0.225). Hematoma was detected in three patients in the exposed group while RLN injury was detected in 5 patients in total (2 in group 1 and 3 in group 2) without any significant difference. There was significant hypocalcemia in favor of the non-exposed group (P = 0.001). Regarding the postoperative hospital stay, there was no significant difference between both groups (P = 0.720). Exposure versus non-exposure of the RLN is still considered a matter of debate but precautions during dissection are a very useful maneuver. Meanwhile, it is better to expose the nerve with meticulous dissection and preservation of the parathyroid gland vascularity.