Our Summary

This research paper discusses ways to safely remove the thyroid gland (a procedure known as a thyroidectomy), in order to prevent damaging a specific nerve in the throat called the recurrent laryngeal nerve. This nerve is important for speaking, so damaging it could cause voice problems.

The researchers looked at the outcomes of thyroidectomy surgeries in 342 patients ranging from 20 to 80 years old. They also studied the location and pathways of the recurrent laryngeal nerve in the throats of deceased patients. They discovered that the location of this nerve can vary in patients with certain types of thyroid diseases.

Comparing the data from the surgeries and the studies on the deceased patients showed that the recurrent laryngeal nerve could potentially be damaged during surgery on the thyroid gland, esophagus and trachea.

Based on this, the researchers stressed the importance of carefully visualizing and moving the recurrent laryngeal nerve during any procedures on the thyroid gland to avoid damaging it. They developed a specific surgical technique to do this and trained surgeons on this technique.

As a result, they were able to reduce the number of patients who had voice problems after the surgery from about 22% to around 1%. They concluded that thyroidectomy can be a safe procedure if surgeons are familiar with the surgical technique and take steps to prevent damage to the important structures in the throat.

FAQs

  1. What is the recurrent laryngeal nerve and why is it important in thyroidectomy surgeries?
  2. How did the researchers develop a new technique to reduce damage to the recurrent laryngeal nerve during thyroidectomy surgeries?
  3. What was the impact of the new surgical technique on the rates of voice problems after thyroidectomy surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about thyroidectomy is to make sure to discuss the risks and potential complications of the surgery, including the possibility of damage to the recurrent laryngeal nerve. It is important for patients to ask their surgeon about their experience with thyroidectomy procedures and what steps they will take to protect the nerves in the throat during surgery. Additionally, patients should follow all pre-operative and post-operative instructions provided by their healthcare team to ensure a successful recovery.

Suitable For

Patients who are typically recommended for thyroidectomy include those with thyroid cancer, large goiters causing difficulty breathing or swallowing, hyperthyroidism that does not respond to other treatments, and suspicious nodules on the thyroid gland. Additionally, patients with a family history of thyroid cancer or certain genetic conditions may also be recommended for thyroidectomy as a preventive measure.

Timeline

Before a thyroidectomy:

  1. Patient undergoes a thorough evaluation by a healthcare provider to determine the need for surgery.
  2. Patient may undergo pre-operative tests such as blood work, imaging studies, and thyroid function tests.
  3. Patient receives instructions on pre-operative preparations, such as fasting before surgery and stopping certain medications.
  4. Patient meets with the surgeon to discuss the procedure, potential risks and benefits, and what to expect during and after surgery.

After a thyroidectomy:

  1. Patient is monitored closely in the recovery room for any immediate post-operative complications.
  2. Patient may experience temporary hoarseness or difficulty speaking due to swelling or damage to the recurrent laryngeal nerve.
  3. Patient is given pain medication and instructions on wound care and activity restrictions.
  4. Patient may need to take thyroid hormone replacement medication for the rest of their life to maintain normal thyroid function.
  5. Patient follows up with the surgeon for post-operative care and monitoring, including monitoring for any signs of complications such as infection or recurrence of thyroid disease.

What to Ask Your Doctor

Some questions a patient should ask their doctor about thyroidectomy include:

  1. What are the potential risks and complications of thyroidectomy, particularly in relation to damaging the recurrent laryngeal nerve?
  2. What specific steps will you take during the surgery to ensure the safety of the recurrent laryngeal nerve?
  3. How experienced are you in performing thyroidectomy surgeries, and what is your success rate in preventing nerve damage?
  4. Will I need to undergo any additional tests or imaging to assess the location of the recurrent laryngeal nerve before the surgery?
  5. What is the recovery process like after a thyroidectomy, and what kind of follow-up care will I need?
  6. Are there any alternative treatment options to thyroidectomy that I should consider?
  7. What can I do to prepare for the surgery and optimize my chances of a successful outcome?
  8. How long will I need to stay in the hospital after the surgery, and when can I expect to return to normal activities?
  9. Are there any potential long-term effects or complications of thyroidectomy that I should be aware of?
  10. Can you provide me with information on your experience and success rate with this specific surgical technique for thyroidectomy?

Reference

Authors: Belokonev VI, Pushkin SY, Kovaleva ZV, Chemidronov SN, Bezzubov AR, Galstyan NE. Journal: Khirurgiia (Mosk). 2022;(6):62-71. doi: 10.17116/hirurgia202206162. PMID: 35658138