Abstract

New Approaches to Reconstruct the Laryngeal Recurrent Nerve after Injury during Thyroidectomy

Thyroidectomy is the most common procedure in head and neck surgery as well as in endocrine surgery. The NRL might be inadvertently injured in 1 to 3 % of the cases, sometimes it also must be sacrificed as part of the thyroidectomy when it is involved, and if a shaving procedure is no possible. The consequent morbidity is related to dysphonia and glottic insufficiency that may last for a long time and usually affects quality of life and increases health care costs, including phoniatric therapy or additional procedures like vocal cord medialization. If bilateral paralysis is present a tracheotomy may be necessary. A comprehensive knowledge of neck anatomy and its variations as well as a careful dissection is necessary to avoid its lesion; Its clear that the best treatment is prevention, but once the lesion of the recurrent laryngeal nerve is stablished, if possible every effort to reconstruct the nerve must be done. Different techniques have been proposed with variable results. We propose to reconstruct of the recurrent laryngeal nerve with a loop of the vagus nerve and perform a termino-terminal anastomosis as a novel technique with promising results.


Author(s): Chala Andres, Valencia Maurici, Gomez JF and Orozco A

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