1997 Volume 9 Issue 2 Pages 150-155
The risk factors for postoperative recurrent laryngeal nerve palsy (RLNP) were analyzed in 1293 patients with thyroid cancer treated between 1991 and 1995. The survival rate was also evaluated in another set of 469 patients with papillary thyroid cancer adherent to the recurrent laryngeal nerve (RLN), treated between 1971 and 1989.
Of the 1293 patients, 150 developed RLNP (11.6%). On univariate analysis, age, size of cancer tumor, and adhesion of the tumor to the RLN were identified as significant risk factors for occurence of RLNP. The results of multivariate analysis revealed that the size of the cancer tumor.
and adhesion of the tumor to the RLN were significant. 102 of 118 patients with RLNP (86.4%) recovered the function of the RLN. The recovery rate (79.4%) of RLNP in 63 patients whose RLNP adhered by the tumor was significantly worse than that (94.5%) in 55 patients whose RLNP was free from tumor. In 469 patients with papillary thyroid cancer involving the RLN, disease-specific and recurrencefree survival rates were not significantly different between 384 patients with preserved RLN and 85 patients whose RLN was excised.
It was pointed out that cancer tumor adhered to the RLN resulted in a high risk for postoperative RLNP. The RLN should be preserved if feasible, because local recurrence rarely developed after releasing the RLN from thyroid cancer.
