Full Text:   <3239>

CLC number: R58

On-line Access: 

Received: 2008-01-25

Revision Accepted: 2008-04-04

Crosschecked: 0000-00-00

Cited: 4

Clicked: 5944

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
Open peer comments

Journal of Zhejiang University SCIENCE B 2008 Vol.9 No.6 P.482-488


Total thyroidectomy is safer with identification of recurrent laryngeal nerve

Author(s):  Hakan CANBAZ, Musa DIRLIK, Tahsin COLAK, Koray OCAL, Tamer AKCA, Oner BILGIN, Bahar TASDELEN, Suha AYDIN

Affiliation(s):  Department of General Surgery, Faculty of Medicine, Mersin University, 33079 Mersin, Turkey; more

Corresponding email(s):   canbazhakan@yahoo.com

Key Words:  Total thyroidectomy, Lobectomy, Recurrent laryngeal nerve (RLN) identification, Complication

Hakan CANBAZ, Musa DIRLIK, Tahsin COLAK, Koray OCAL, Tamer AKCA, Oner BILGIN, Bahar TASDELEN, Suha AYDIN. Total thyroidectomy is safer with identification of recurrent laryngeal nerve[J]. Journal of Zhejiang University Science B, 2008, 9(6): 482-488.

@article{title="Total thyroidectomy is safer with identification of recurrent laryngeal nerve",
author="Hakan CANBAZ, Musa DIRLIK, Tahsin COLAK, Koray OCAL, Tamer AKCA, Oner BILGIN, Bahar TASDELEN, Suha AYDIN",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Total thyroidectomy is safer with identification of recurrent laryngeal nerve
%A Tahsin COLAK
%A Koray OCAL
%A Tamer AKCA
%J Journal of Zhejiang University SCIENCE B
%V 9
%N 6
%P 482-488
%@ 1673-1581
%D 2008
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B0820033

T1 - Total thyroidectomy is safer with identification of recurrent laryngeal nerve
A1 - Hakan CANBAZ
A1 - Musa DIRLIK
A1 - Tahsin COLAK
A1 - Koray OCAL
A1 - Tamer AKCA
A1 - Oner BILGIN
A1 - Suha AYDIN
J0 - Journal of Zhejiang University Science B
VL - 9
IS - 6
SP - 482
EP - 488
%@ 1673-1581
Y1 - 2008
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B0820033

Objective: To investigate the effect of recurrent laryngeal nerve (RLN) identification on the complications after total thyroidectomy and lobectomy. Methods: Total 134 consecutive patients undergoing total thyroidectomy or thyroid lobectomy from January 2003 to November 2004 were investigated retrospectively. Patients were divided into two groups: RLN identified (Group A) or not (Group B). The two groups were compared for RLN injury and hypocalcaemia. Results: The numbers of patients and nerves at risk were 71 and 129 in Group A, and 63 and 121 in Group B, respectively. RLN injury in Group A (0) was significantly lower than that in Group B (5 [7.9%]) patients, 7 [5.8%] nerves) for the numbers of patients (P=0.016) and nerves at risk (P=0.006). Temporary hypocalcaemia was significantly higher in Group A than in Group B (14 [24.1%] vs 6 [10.3%], P=0.049). Permanent complications in Group B were significantly higher than those in Group A (13 [20.6%] vs 4 [5.6%], P=0.009). Conclusion: RLN injury was prevented and permanent complications were decreased by identifying the whole course and branches of the recurrent laryngeal nerve during total thyroidectomy.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


[1] Ardito, G., Revelli, L., D′Alatri, L., Lerro, V., Guidi, M.L., Ardito, F., 2004. Revisited anatomy of the recurrent laryngeal nerves. Am. J. Surg., 187(2):249-253.

[2] Bergamaschi, R., Becouarn, G., Ronceray, J., 1998. Morbidity of thyroid surgery. Am. J. Surg., 176(1):71-75.

[3] Betka, J., Mrzena, L., Astl, J., Nemec, J., Vlcek, P., Taudy, M., Skrivan, J., 1997. Surgical treatment strategy for thyroid gland carcinoma nodal metastases. Eur. Arch. Otorhinolaryngol., 254(s1):169-174.

[4] Bron, L.P., O′Brien, C.J., 2004. Total thyroidectomy for clinically benign disease of the thyroid gland. Br. J. Surg., 91(5):569-574.

[5] Dackiw, A.P.B., Rotstein, L.E., Clark, O.H., 2002. Computer-assisted evoked electromyography with stimulating surgical instruments for recurrent/external laryngeal nerve identification and preservation in thyroid and parathyroid operation. Surgery, 132(6):1100-1108.

[6] Dener, C., 2002. Complication rates after operations for benign thyroid disease. Acta Otolaryngol., 122(6):679-683.

[7] Erolu, A., Ünal, M., Kocaolu, H., 1998. Total thyroidectomy for differentiated thyroid carcinoma: primary and secondary operations. Eur. J. Surg. Oncol., 24(4):283-287.

[8] Harness, J.K., Fung, L., Thompson, N.W., Burney, R.E., McCleod, M.K., 1986. Total thyroidectomy: complications and technique. World J. Surg., 10(5):781-786.

[9] Hermann, M., Alk, G., Roka, R., Glaser, K., Freissmuth, M., 2002. Laryngeal recurrent nerve injury in surgery for benign thyroid diseases. Effect of nerve dissection and impact of individual surgeon in more than 27000 nerves at risk. Ann. Surg., 235(2):261-268.

[10] Hisham, A.N., Lukman, M.R., 2002. Recurrent laryngeal nerve in thyroid surgery: a critical appraisal. ANZ J. Surg., 72(12):887-889.

[11] Lo, C.Y., 2002. Parathyroid transplantation during thyroidectomy. ANZ J. Surg., 72(12):902-907.

[12] Mattig, H., Bildat, D., Metzger, B., 1998. Reducing the rate of recurrent nerve paralysis by routine exposure of the nerves in thyroid gland operations. Zentralbl. Chir., 123(1):17-20.

[13] McHenry, C.R., 2002. Patient volumes and complications in thyroid surgery. Br. J. Surg., 89(7):821-823.

[14] Megherbi, M.T., Graba, A., Abid, L., Oulmane, D., Saidani, M., Benabadji, R., 1992. Complications and squeal of benign thyroid surgery. J. Chir. (Paris), 129(1):41-46.

[15] Ozbas, S., Kocak, S., Aydıntug, S., Cakmak, A., Demirkıran, M.A., Wishart, G.C., 2005. Comparison of the complications of subtotal, near total and total thyroidectomy in the surgical management of multinodular goiter. Endocrine J., 52(2):199-205.

[16] Pappalardo, G., Guadalaxara, A., Frattaroli, F.M., Illomei, G., Falaschi, P., 1998. Total compared with subtotal thyroidectomy in benign nodular disease: personal series and review of published reports. Eur. J. Surg., 164(7):501-506.

[17] Pimpl, W., Rieger, R., Waclawiczek, H.W., Meiser, G., Zukriegel, M., Boeckl, O., 1992. Technique of recurrent laryngeal nerve exposure within the scope of interventions of the thyroid gland. Wien. Klin. Wochenschr., 104(15):439-442.

[18] Rosato, L., Avenia, N., Bernante, P., De Palma, M., Gulino, G., Nasi, P.G., Pelizzo, M.R., Pezzullo, L., 2004. Complications of thyroid surgery: analysis of a multicentric study on 14934 patients operated on in Italy over 5 years. World J. Surg., 28(3):271-276.

[19] Shaha, A.R., Jaffe, B.M., 1992. Completion thyroidectomy: a critical appraisal. Surgery, 112(6):1148-1152.

[20] Sturniolo, G., D′Alia, C., Tonante, A., Gagliano, E., Taranto, F., Lo Schiavo, M.G., 1999. The recurrent laryngeal nerve related to thyroid surgery. Am. J. Surg., 177(6):485-488.

[21] Thomusch, O., Sekulla, C., Dralle, H., 2003. Is primary total thyroidectomy justified in benign multinodular goiter? Results of a prospective quality assurance study of 45 hospitals offering different levels of care. Der Chirurg, 74(5):437-443 (In German).

[22] Wagner, H.E., Seiler, C., 1994. Recurrent laryngeal nerve injury after throid gland surgery. Br. J. Surg., 81(2):226-228.

[23] Zambudio, A.R., Rodriguez, J., Riquelme, J., Soria, T., Canteras, M., Parrilla, P., 2004. Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery. Ann. Surg., 240(1):18-25.

[24] Zedenius, J., Wadstrom, C., Delbridge, L., 1999. Routine autotransplantation of at least one parathyroid gland during total thyroidectomy may reduce permanent hypoparathyroidism to zero. ANZ J. Surg., 69(11):794-797.

Open peer comments: Debate/Discuss/Question/Opinion


Please provide your name, email address and a comment

Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2024 Journal of Zhejiang University-SCIENCE