Preventing nerve damage during total thyroidectomy or total lobectomy surgeries

AbdulWahid M. Salih; Hawar Hasan Ali; Diary A. smael; Mohammed I. Gubari; Karzan Mohammed Salih; Masrur Sleman Aziz

doi:10.15218/zjms.2016.0036

Authors

AbdulWahid M. Salih Department of Surgery, School of Medicine, Sulaimani University, Sulaimani, Iraq
Hawar Hasan Ali Surgical Unit, Shar Hospital, Sulaimani, Iraq
Diary A. smael Department of Surgery, School of Medicine, Sulaimani University, Sulaimani, Iraq
Mohammed I. Gubari Department of Community Health, Sulaimani Polytechnic University, Sulaimani, Iraq.
Karzan Mohammed Salih Department of Surgery, School of Medicine, Sulaimani University, Sulaimani, Iraq
Masrur Sleman Aziz Department of Surgery, School of Medicine, Sulaimani University, Sulaimani, Iraq.

DOI:

https://doi.org/10.15218/zjms.2016.0036

Keywords:

Thyroidectomy, Lobectomy, Nerve damage

Abstract

Background and objective: Thyroidectomy is an operation that involves surgical removal of all or part of the thyroid gland. The main postoperative complications of thyroidectomy are hypoparathyroidism and recurrent laryngeal nerve injury. This study aimed to find out the main postoperative complications particularly nerve damage during total thyroidectomy or total lobectomy.

Methods: The medical records of patients who were diagnosed with thyroid disease and underwent surgery between January 2^nd, 2013 and December 30^th, 2014 in Teaching, Shar, Soma and Zhian hospitals in Sulaimaniyah were retrospectively reviewed.

Results: All patients who underwent total thyroidectomy or total lobectomy surgeries were discharged within 24 hours of the operation. During the average follow-up of 24 months, no case of permanent recurrent laryngeal nerve injury was registered. Vocal cord paralysis was considered to be present, when there was absent or markedly reduced movement of the affected vocal cord.

Conclusions: Meticulous hemostasis and a delicate technique are required to prevent nerve injury. We recommend dissection and division of all the vessels flush with the thyroid capsule at the anterior and peripheral aspect of the gland. Separate ligation of anterior and posterior branched of the superior thyroid artery will preserve the external branch of the superior laryngeal nerves.

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