Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-26T08:32:17.204Z Has data issue: false hasContentIssue false
  • English
  • Français

Relationship of the recurrent laryngeal nerve to the superior parathyroid gland during thyroidectomy

Published online by Cambridge University Press:  25 March 2014

Michael Persky ,
Y Fang  and
D Myssiorek
Michael Persky
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, USA
Y Fang
Affiliation:
Division of Biostatistics, Department of Population Health, New York University School of Medicine, USA
D Myssiorek*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, USA
*
Address for correspondence: Dr D Myssiorek, NYU Clinical Cancer Center, 160 E34th Street, New York, NY 10016, USA Fax: 001 212 731 5502 E-mail: David.Myssiorek@nyumc.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Design:

The relationship of the recurrent laryngeal nerve to the superior parathyroid gland during consecutive thyroidectomies was prospectively evaluated. When one structure was noted, careful dissection was performed to locate the other structure, to preserve their natural anatomical relationship.

Patients:

In total, 103 consecutive thyroid lobectomies were performed on 73 patients. The distance from the superior parathyroid gland to the recurrent laryngeal nerve was recorded.

Results:

In 88 cases (88.9 per cent), the superior parathyroid gland was identified within 5 mm of the recurrent laryngeal nerve. In 62 cases (62.6 per cent), the gland was within 1 mm of the recurrent laryngeal nerve. The height of the thyroid lobe was positively associated with the distance between the two structures (p = 0.001), as was the incidence of cancer (p = 0.033). The incidence of recurrent laryngeal nerve paresis was less than 4 per cent.

Conclusion:

In most cases, the recurrent laryngeal nerve was found in close proximity to the superior parathyroid gland. In a thyroid gland with a large height, or in a cancerous lobe, this relationship is less reliable.

Keywords

Recurrent Laryngeal NerveDiagnosisAnatomyParathyroid GlandThyroidectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 4 , April 2014 , pp. 368 - 371
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Jatzko, GR, Lisborg, PH, Müller, MG, Wette, VM. Recurrent nerve palsy after thyroid operations--principal nerve identification and a literature review. Surgery 1994;115:139–44Google ScholarPubMed
2Abadin, SS, Kaplan, EL, Angelos, P. Malpractice litigation after thyroid surgery: the role of recurrent laryngeal nerve injuries, 1989–2009. Surgery 2010;148:718–22Google Scholar
3Richer, SL, Randolph, GW. Management of the recurrent laryngeal nerve in thyroid surgery. Oper Tech Otolaryngol Head Neck Surg 2009;20:29–34CrossRefGoogle Scholar
4Shindo, ML, Wu, JC, Park, EE. Surgical anatomy of the recurrent laryngeal nerve revisited. Otolaryngol Head Neck Surg 2005;133:514–19CrossRefGoogle ScholarPubMed
5Lo, CY, Kwok, KF, Yuen, PW. A prospective evaluation of recurrent laryngeal nerve paralysis during thyroidectomy. Arch Surg 2000;135:204–7CrossRefGoogle ScholarPubMed
6Zakaria, HM, Al Awad, NA, Al Kreedes, AS. Recurrent laryngeal nerve injury in thyroid surgery. Oman Med J 2011;26:34–8Google Scholar