Summary:
Objective:Based on their on experience the authors express their opinion on routine detection and visualiza-
tion of the NLR during radical surgery of the thyroid gland.They describe standard and alternative steps of
surgery leading to protection of the recurrent nerve.
Material and methods:The authors evaluated a group of 735 patients operated during the last thirty nine
months which comprised 87%total thyroidectomies,11.6%total lobectomies,the remainder were almost total
operations.The number of visualized nerves was 1367.
Results:Unilateral temporary damage of the NLR leading to temporary pareses of the vocal cords was
recorded in 19 patients,i.e.1.39%,bilateral transient paresis in one case,i.e.0.07%.Permanent damage of one
vocal cord after severing of the NLR occurred in 11 patients,i.e.0.8%,bilateral lesions of the vocal cords were
not recorded.
Conclusion:There are no extensive statistics of thyroid operations without reports on damage of the NLR.
With the increasing number of radical operations of the gland also the number of departments increased which
recommend unequivocally to seek and visualize the NLR.The authors results support this point of view.They
use most frequently a modification of Wang ’s method and consider as the smallest extent of visualization of the
NLR the distance between the branching of the inferior thyroid artery and the entry of the NLR into the larynx.
Key words:
thyroidectomy –nervus laryngeus recurrens –visualization of NLR –complications of thyroi-
dectomy
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