Recurrent Laryngeal Nerve Damage After Thyroid Surgery

Q: Recurrent Laryngeal Nerve Damage After Thyroid Surgery

Hello Miss Tiffany： The surgical options include the use of Teflon, nerve repair surgery, which requires a joint consultation among a neurosurgeon, an otolaryngologist, and the original surgeon, to make a decision based on the patient's condition.

Recurrent laryngeal nerve

Your question: Hello Doctor, if the recurrent laryngeal nerve is affected during thyroid surgery and the vocal cords do not recover on their own after six months, will they never recover, and will surgery be necessary to correct the vocal cords? Thank you...
Response from the physician: ENT specialist, Dr.
Chen Junliang suggests: If the recurrent laryngeal nerve is injured during thyroid surgery, and after six months of observation and treatment there is still no recovery, the chances of recovery are lower.
Unless there is a severe injury, neurosurgical intervention may be considered, but the outcomes are not guaranteed.
Your question: So, will surgery be necessary for improvement?

tiffany, 20~29 year old female. Ask Date: 2003/08/26

Dr. Chen Junliang reply Otolaryngology

Hello Miss Tiffany: The surgical options include the use of Teflon, nerve repair surgery, which requires a joint consultation among a neurosurgeon, an otolaryngologist, and the original surgeon, to make a decision based on the patient's condition.

Reply Date: 2003/08/26

More Info

Recurrent laryngeal nerve (RLN) damage is a known complication of thyroid surgery, particularly when the thyroid gland is enlarged or when there is a need to remove nearby lymph nodes. The RLN is responsible for innervating the muscles that control the vocal cords, and damage to this nerve can lead to vocal cord paralysis, resulting in hoarseness, difficulty speaking, and potential breathing issues.

When a patient experiences RLN damage post-thyroid surgery, the timeline for recovery can vary significantly. In many cases, if the nerve has been bruised but not completely severed, there is a chance for spontaneous recovery within the first few months. Studies have shown that the majority of patients who experience temporary vocal cord paralysis due to RLN injury may see improvement within six months. However, if there is no improvement after this period, the likelihood of recovery diminishes significantly.

If a patient has not regained vocal cord function after six months, it is essential to consider the extent of the nerve injury. If the nerve has been completely severed, surgical intervention may be necessary. Options include nerve grafting or procedures to reposition the vocal cords, such as thyroplasty, which can help improve voice quality and airway function.

It is important to note that the decision to undergo further surgery should be made in consultation with an otolaryngologist (ENT specialist) who can assess the specific circumstances of the injury. They may recommend imaging studies or laryngoscopy to evaluate the status of the vocal cords and the nerve.

In addition to surgical options, voice therapy can be beneficial for patients with RLN damage. A speech-language pathologist can work with the patient to develop strategies to improve vocal function and compensate for any deficits. This therapy can be particularly useful in cases where surgery is not immediately indicated or if the patient prefers to explore non-surgical options first.

In summary, if a patient has not seen improvement in vocal cord function six months after RLN injury due to thyroid surgery, the chances of spontaneous recovery are low. Surgical options may be considered, particularly if the injury is severe. However, voice therapy should also be explored as a complementary approach to help manage symptoms and improve quality of life. Regular follow-ups with healthcare providers are crucial to monitor progress and make informed decisions about treatment options.

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