Lesions of the Laryngeal Nerves during Thyroidectomy - What s NewR. Popescu, S. Constantinoiu
General reports, no. 4, 2014
Lesions to the laryngeal nerves, despite their low incidence, arethe most severe long term complications after thyroidectomy.Visualization after careful dissection of the recurrent laryngealnerve (RLN) is now the gold standard among thyroid surgeons.The Zuckerkandl tubercle (TZ) is a constant landmark for theidentification of the RLN. Recent studies show the occurrenceof two or more branches of RLN before entering the larynx.Knowledge about their existence could prevent lesions. Somehigh risk surgical situations are evidenced, such as: nonrecurrentlaryngeal nerve emerging high from the vagus and thesuperior laryngeal nerve type Cernea 2. Several examinationprocedures are mandatory for a complete postoperativeevaluation: video laryngoscopy and laryngeal electromyography(LEMG) bring valuable objective and prognostic data. However,due to the unpredictability of the synkynesis process, theprognosis of recovery in RLN injuries remains difficult.