Thyroid lobe size predicts risk of postoperative temporary recurrent laryngeal nerve paralysis
Abstract Objectives In patients who had undergone thyroidectomy in Japan for benign tumor, we determined whether thyroid lobe size correlates with temporary recurrent laryngeal nerve paralysis (T‐RLNP). Methods We retrospectively collected medical record data on usage of intraoperative neuromonitori...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-12-01
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| Series: | Laryngoscope Investigative Otolaryngology |
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| Online Access: | https://doi.org/10.1002/lio2.321 |
| _version_ | 1818972639890243584 |
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| author | Nobuyoshi Tsuzuki Koichiro Wasano Taiji Kawasaki Shun‐ichi Sasaki Kaoru Ogawa |
| author_facet | Nobuyoshi Tsuzuki Koichiro Wasano Taiji Kawasaki Shun‐ichi Sasaki Kaoru Ogawa |
| author_sort | Nobuyoshi Tsuzuki |
| collection | DOAJ |
| description | Abstract Objectives In patients who had undergone thyroidectomy in Japan for benign tumor, we determined whether thyroid lobe size correlates with temporary recurrent laryngeal nerve paralysis (T‐RLNP). Methods We retrospectively collected medical record data on usage of intraoperative neuromonitoring, laterality of thyroidectomy, amount of bleeding during surgery, duration of surgery, and whether the surgeon was a board certified otorhinolaryngologist as determined by the Oto‐Rhino‐Laryngological Society of Japan. Thyroid size was measured in preoperative axial computed tomography (CT) images. Receiver operating characteristic (ROC) curve analysis was used to determine the thyroid size that predicted a high risk of T‐RLNP or permanent recurrent laryngeal nerve paralysis (P‐RLNP). Results Of the 146 eligible patients identified, 9 (6.2%) developed T‐RLNP and 2 (1.4%) developed P‐RLNP. The amount of bleeding during thyroidectomy was significantly greater in T‐RLNP patients than in P‐RLNP patients. Thyroid sizes in CT images were significantly larger in T‐RLNP patients compared to patients who did not develop RLNP (referred to hereafter as N‐RLNP). ROC analysis revealed that 1.3% of thyroid lobes with an area of less than 1000.0 mm2, and 9.9% of thyroid lobes with an area of greater than 1000.0 mm2 were at risk for T‐RLNP. Conclusion We presented evidence that thyroid sizes, as measured on preoperative axial CT images, were larger in T‐RLNP patients than in N‐RLNP patients. Our results indicate a connection between benign thyroid tumor stretch injuries and T‐RLNP. Level of Evidence IV. |
| first_indexed | 2024-12-20T15:11:28Z |
| format | Article |
| id | doaj.art-2af81d44780845a8874b4c3d5f932f00 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-12-20T15:11:28Z |
| publishDate | 2019-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-2af81d44780845a8874b4c3d5f932f002022-12-21T19:36:19ZengWileyLaryngoscope Investigative Otolaryngology2378-80382019-12-014670871310.1002/lio2.321Thyroid lobe size predicts risk of postoperative temporary recurrent laryngeal nerve paralysisNobuyoshi Tsuzuki0Koichiro Wasano1Taiji Kawasaki2Shun‐ichi Sasaki3Kaoru Ogawa4Department of Otolaryngology Japanese Red Cross Shizuoka Hospital Shizuoka JapanNational Hospital Organization Tokyo Medical Center National Institute of Sensory Organs Tokyo JapanDepartment of Otolaryngology Japanese Red Cross Shizuoka Hospital Shizuoka JapanDepartment of Otolaryngology Japanese Red Cross Ashikaga Hospital Tochigi JapanDepartment of Otolaryngology Head and Neck Surgery, Keio University School of Medicine Tokyo JapanAbstract Objectives In patients who had undergone thyroidectomy in Japan for benign tumor, we determined whether thyroid lobe size correlates with temporary recurrent laryngeal nerve paralysis (T‐RLNP). Methods We retrospectively collected medical record data on usage of intraoperative neuromonitoring, laterality of thyroidectomy, amount of bleeding during surgery, duration of surgery, and whether the surgeon was a board certified otorhinolaryngologist as determined by the Oto‐Rhino‐Laryngological Society of Japan. Thyroid size was measured in preoperative axial computed tomography (CT) images. Receiver operating characteristic (ROC) curve analysis was used to determine the thyroid size that predicted a high risk of T‐RLNP or permanent recurrent laryngeal nerve paralysis (P‐RLNP). Results Of the 146 eligible patients identified, 9 (6.2%) developed T‐RLNP and 2 (1.4%) developed P‐RLNP. The amount of bleeding during thyroidectomy was significantly greater in T‐RLNP patients than in P‐RLNP patients. Thyroid sizes in CT images were significantly larger in T‐RLNP patients compared to patients who did not develop RLNP (referred to hereafter as N‐RLNP). ROC analysis revealed that 1.3% of thyroid lobes with an area of less than 1000.0 mm2, and 9.9% of thyroid lobes with an area of greater than 1000.0 mm2 were at risk for T‐RLNP. Conclusion We presented evidence that thyroid sizes, as measured on preoperative axial CT images, were larger in T‐RLNP patients than in N‐RLNP patients. Our results indicate a connection between benign thyroid tumor stretch injuries and T‐RLNP. Level of Evidence IV.https://doi.org/10.1002/lio2.321benignrecurrent laryngeal nervethyroidthyroidectomyvocal cord paralysis |
| spellingShingle | Nobuyoshi Tsuzuki Koichiro Wasano Taiji Kawasaki Shun‐ichi Sasaki Kaoru Ogawa Thyroid lobe size predicts risk of postoperative temporary recurrent laryngeal nerve paralysis Laryngoscope Investigative Otolaryngology benign recurrent laryngeal nerve thyroid thyroidectomy vocal cord paralysis |
| title | Thyroid lobe size predicts risk of postoperative temporary recurrent laryngeal nerve paralysis |
| title_full | Thyroid lobe size predicts risk of postoperative temporary recurrent laryngeal nerve paralysis |
| title_fullStr | Thyroid lobe size predicts risk of postoperative temporary recurrent laryngeal nerve paralysis |
| title_full_unstemmed | Thyroid lobe size predicts risk of postoperative temporary recurrent laryngeal nerve paralysis |
| title_short | Thyroid lobe size predicts risk of postoperative temporary recurrent laryngeal nerve paralysis |
| title_sort | thyroid lobe size predicts risk of postoperative temporary recurrent laryngeal nerve paralysis |
| topic | benign recurrent laryngeal nerve thyroid thyroidectomy vocal cord paralysis |
| url | https://doi.org/10.1002/lio2.321 |
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