European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 8, pp 2267–2276 | Cite as

Risk factors for recurrent nerve palsy after thyroid surgery: a national study of patients treated at Danish departments of ENT Head and Neck Surgery

  • Christian GodballeEmail author
  • Anders Rørbæk Madsen
  • Christian Hjort Sørensen
  • Sten Schytte
  • Waldemar Trolle
  • Jens Helweg-Larsen
  • Lisa Barfoed
  • Larry Kristiansen
  • Vibeke Zederkof Sørensen
  • Grethe Samuelsen
  • Henrik Baymler Pedersen
Head and Neck


Recurrent laryngeal nerve (RLN) injury is a well-known and serious complication to thyroid surgery. The objective was to estimate the frequency of post-thyroidectomy RLN palsy and to identify possible risk factors. Based on the Danish national thyroid surgery database, 6,859 patients treated with thyroid surgery from 1 January 2001 to the 31 December 2008 at the Danish departments of ENT-HNS were analyzed. Unilateral RLN palsy was found in 2.1 % and bilateral in 0.1 %. In benign histology, RLN palsies were registered in 1.3 %. Malignant histology and accordingly neck dissection were the most predominant risk factors with a relative risk (RR) of 5.4 and 5.8, respectively. In benign cases previous performed thyroid surgery had a RR of 10.4. High volume departments with more than 150 thyroid procedures per year seem to perform significantly better. Malignant histology, neck dissection and previous performed thyroid surgery are the strongest predictors for RLN palsy and patient information should be given accordingly. Incomplete resections should be reserved for isthmectomy only. Centralization of thyroid surgery in larger units might improve quality.


Thyroid surgery Recurrent nerve palsy Risk factors National study 



We thank all colleagues who have participated in the establishment of the actual dataset.

According to Danish law permission to collect patient data has been approved by the Danish Data Protection Agency (journal number 2000-41-0010). The local ethical committee has been informed about the project.

Conflict of interest

The authors have no conflicts of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Christian Godballe
    • 1
    Email author
  • Anders Rørbæk Madsen
    • 1
  • Christian Hjort Sørensen
    • 2
  • Sten Schytte
    • 3
  • Waldemar Trolle
    • 4
  • Jens Helweg-Larsen
    • 5
  • Lisa Barfoed
    • 6
  • Larry Kristiansen
    • 7
  • Vibeke Zederkof Sørensen
    • 8
  • Grethe Samuelsen
    • 9
  • Henrik Baymler Pedersen
    • 10
  1. 1.Department of ENT Head and Neck SurgeryOdense University HospitalOdense CDenmark
  2. 2.Department of ENT Head and Neck SurgeryGentofte HospitalHellerupDenmark
  3. 3.Department of ENT Head and Neck SurgeryAarhus University HospitalAarhusDenmark
  4. 4.Department of ENT Head and Neck Surgery, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
  5. 5.Department of ENT Head and Neck SurgeryVejle HospitalVejleDenmark
  6. 6.Department of ENT Head and Neck SurgerySlagelse HospitalSlagelseDenmark
  7. 7.Department of ENT Head and Neck SurgeryViborg HospitalViborgDenmark
  8. 8.Department of ENT Head and Neck SurgeryKøge HospitalKøgeDenmark
  9. 9.Department of ENT Head and Neck SurgeryHillerød HospitalHillerødDenmark
  10. 10.Department of ENT Head and Neck SurgeryAalborg University HospitalAalborgDenmark

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