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Recurrent Laryngeal Nerve Injury After Thyroid Surgery at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia

Received: 18 May 2024    Accepted: 7 June 2024    Published: 3 July 2024
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Abstract

Background: Recurrent laryngeal nerve (RLN) injury, a dreaded complication in thyroid surgery, remains a concern even in the hands of seasoned surgeons. It stands as a significant cause for medical malpractice claims against surgeons. Objective: To assess the Magnitude of RLN injury and associated factors in patients undergoing thyroid surgery at St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia, from May 1st, 2021, to April 30th, 2022. Methods: A facility-based, observational study was conducted at SPHMMC, Addis Ababa, Ethiopia. Data was collected using a structured questionnaire designed with Google Forms. A census sampling approach was used to select the data charts to ensure a comprehensive perspective. This method ensured a representative sample of the population under study, enhancing the reliability of the results. The information was transferred to Excel and then imported into SPSS. Descriptive statistics were employed to summarize the key characteristics within the dataset concisely. Stepwise multiple logistic regression was implemented to explore the potential relationships between the independent and dependent variables. A significance level of p < 0.05 was adopted to identify statistically meaningful results. The findings are presented through a combination of text, tables, and figures. Results: The study included a total of 185 patients, with a mean± SD age of 41.62 ± 12.72 and a median age of 40. Females constituted 78.9% of the participants. The study's key finding is a persistent RLN injury rate of 5.4% (10/185). After adjusting for other covariates, the odds of developing persistent RLN injury were found to be 30 times higher among patients who had central neck dissection than those who had not undergone central neck dissection (AOR=30.0, 95%CI=4.3,211.9, p-value=0.001). However, sex, substernal goiter, histologic finding, preoperative toxicity, extent of thyroidectomy, and identification of RLN intra-operatively were not associated with persistent RLN injury in bivariate logistic regression analysis. Conclusion: This study found a persistent, recurrent laryngeal nerve injury rate of 5.4% in patients undergoing thyroid surgery. Central neck dissection was the only factor significantly associated with an increased risk of recurrent laryngeal nerve injury. These findings suggest minimizing central neck dissection when feasible during thyroid surgery to reduce the risk of this complication.

Published in Journal of Surgery (Volume 12, Issue 4)
DOI 10.11648/j.js.20241204.11
Page(s) 92-98
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Thyroid Surgery, Recurrent Laryngeal Nerve Injury, Vocal Cord Paralysis

References
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[8] Zakaria HM, Al Awad NA, Al Kreedes AS, Al-Mulhim AM, Al-Sharway MA, Hadi MA, et al. Recurrent laryngeal nerve injury in thyroid surgery. Oman Med J. 2011; 26(1): 34-8.
[9] Pardal-Refoyo JL, Parente-Arias P, Arroyo-Domingo MM, Maza-Solano JM, Granell-Navarro J, Martínez-Salazar JM, et al. Recommendations on the use of neuromonitoring in thyroid and parathyroid surgery. Acta Otorrinolaringol Esp (Engl Ed). 2018; 69(4): 231-42.
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Cite This Article
  • APA Style

    Alemayehu, F., Geletu, Z., Birhanu, W., Berhe, L. Z., Ayalew, Z., et al. (2024). Recurrent Laryngeal Nerve Injury After Thyroid Surgery at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Journal of Surgery, 12(4), 92-98. https://doi.org/10.11648/j.js.20241204.11

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    ACS Style

    Alemayehu, F.; Geletu, Z.; Birhanu, W.; Berhe, L. Z.; Ayalew, Z., et al. Recurrent Laryngeal Nerve Injury After Thyroid Surgery at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. J. Surg. 2024, 12(4), 92-98. doi: 10.11648/j.js.20241204.11

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    AMA Style

    Alemayehu F, Geletu Z, Birhanu W, Berhe LZ, Ayalew Z, et al. Recurrent Laryngeal Nerve Injury After Thyroid Surgery at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. J Surg. 2024;12(4):92-98. doi: 10.11648/j.js.20241204.11

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  • @article{10.11648/j.js.20241204.11,
      author = {Fitsum Alemayehu and Zelalem Geletu and Waltengus Birhanu and Lidya Zewdie Berhe and Zekarias Ayalew and Gebeyehu Azibte},
      title = {Recurrent Laryngeal Nerve Injury After Thyroid Surgery at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
    },
      journal = {Journal of Surgery},
      volume = {12},
      number = {4},
      pages = {92-98},
      doi = {10.11648/j.js.20241204.11},
      url = {https://doi.org/10.11648/j.js.20241204.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20241204.11},
      abstract = {Background: Recurrent laryngeal nerve (RLN) injury, a dreaded complication in thyroid surgery, remains a concern even in the hands of seasoned surgeons. It stands as a significant cause for medical malpractice claims against surgeons. Objective: To assess the Magnitude of RLN injury and associated factors in patients undergoing thyroid surgery at St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia, from May 1st, 2021, to April 30th, 2022. Methods: A facility-based, observational study was conducted at SPHMMC, Addis Ababa, Ethiopia. Data was collected using a structured questionnaire designed with Google Forms. A census sampling approach was used to select the data charts to ensure a comprehensive perspective. This method ensured a representative sample of the population under study, enhancing the reliability of the results. The information was transferred to Excel and then imported into SPSS. Descriptive statistics were employed to summarize the key characteristics within the dataset concisely. Stepwise multiple logistic regression was implemented to explore the potential relationships between the independent and dependent variables. A significance level of p Results: The study included a total of 185 patients, with a mean± SD age of 41.62 ± 12.72 and a median age of 40. Females constituted 78.9% of the participants. The study's key finding is a persistent RLN injury rate of 5.4% (10/185). After adjusting for other covariates, the odds of developing persistent RLN injury were found to be 30 times higher among patients who had central neck dissection than those who had not undergone central neck dissection (AOR=30.0, 95%CI=4.3,211.9, p-value=0.001). However, sex, substernal goiter, histologic finding, preoperative toxicity, extent of thyroidectomy, and identification of RLN intra-operatively were not associated with persistent RLN injury in bivariate logistic regression analysis. Conclusion: This study found a persistent, recurrent laryngeal nerve injury rate of 5.4% in patients undergoing thyroid surgery. Central neck dissection was the only factor significantly associated with an increased risk of recurrent laryngeal nerve injury. These findings suggest minimizing central neck dissection when feasible during thyroid surgery to reduce the risk of this complication.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Recurrent Laryngeal Nerve Injury After Thyroid Surgery at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
    
    AU  - Fitsum Alemayehu
    AU  - Zelalem Geletu
    AU  - Waltengus Birhanu
    AU  - Lidya Zewdie Berhe
    AU  - Zekarias Ayalew
    AU  - Gebeyehu Azibte
    Y1  - 2024/07/03
    PY  - 2024
    N1  - https://doi.org/10.11648/j.js.20241204.11
    DO  - 10.11648/j.js.20241204.11
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 92
    EP  - 98
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20241204.11
    AB  - Background: Recurrent laryngeal nerve (RLN) injury, a dreaded complication in thyroid surgery, remains a concern even in the hands of seasoned surgeons. It stands as a significant cause for medical malpractice claims against surgeons. Objective: To assess the Magnitude of RLN injury and associated factors in patients undergoing thyroid surgery at St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia, from May 1st, 2021, to April 30th, 2022. Methods: A facility-based, observational study was conducted at SPHMMC, Addis Ababa, Ethiopia. Data was collected using a structured questionnaire designed with Google Forms. A census sampling approach was used to select the data charts to ensure a comprehensive perspective. This method ensured a representative sample of the population under study, enhancing the reliability of the results. The information was transferred to Excel and then imported into SPSS. Descriptive statistics were employed to summarize the key characteristics within the dataset concisely. Stepwise multiple logistic regression was implemented to explore the potential relationships between the independent and dependent variables. A significance level of p Results: The study included a total of 185 patients, with a mean± SD age of 41.62 ± 12.72 and a median age of 40. Females constituted 78.9% of the participants. The study's key finding is a persistent RLN injury rate of 5.4% (10/185). After adjusting for other covariates, the odds of developing persistent RLN injury were found to be 30 times higher among patients who had central neck dissection than those who had not undergone central neck dissection (AOR=30.0, 95%CI=4.3,211.9, p-value=0.001). However, sex, substernal goiter, histologic finding, preoperative toxicity, extent of thyroidectomy, and identification of RLN intra-operatively were not associated with persistent RLN injury in bivariate logistic regression analysis. Conclusion: This study found a persistent, recurrent laryngeal nerve injury rate of 5.4% in patients undergoing thyroid surgery. Central neck dissection was the only factor significantly associated with an increased risk of recurrent laryngeal nerve injury. These findings suggest minimizing central neck dissection when feasible during thyroid surgery to reduce the risk of this complication.
    
    VL  - 12
    IS  - 4
    ER  - 

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