Risk factors predisposing for recurrent laryngeal nerve palsy following thyroid malignancy surgery: experience from a tertiary oncology centre

  • Supreet Singh Nayyar
  • Shivakumar ThiagarajanEmail author
  • Akshat Malik
  • Adhara Chakraborthy
  • Parthiban Velayutham
  • Devendra Chaukar
Head and Neck



Postoperative recurrent laryngeal nerve (RLN) palsy is one of the major morbidities encountered after thyroid surgery. The risk further increases when surgery is performed for thyroid malignancies.


A retrospective study of patients who underwent hemi, total or completion thyroidectomy at our institute between June 2017 to May 2019 were analyzed. We assessed factors that predisposed to the development of RLN palsy.


The study comprised of 228 patients. A total of 400 nerves were at risk. The RLN palsy rate was 6.8% (n = 27). On univariate and multivariate analysis, the risk of RLN palsy was seen most with pT4a tumor (OR = 8.5), gross extra-thyroidal extension (ETE) (OR = 3.5) and tracheo-esophageal groove (TEG) (OR = 2.8) involvement, followed by aggressive histopathology, and central compartment node positivity.


pT4a tumors, gross ETE, and TEG involvement were the leading causes predisposing for the development of RLN palsy in our series.


Recurrent laryngeal nerve Papillary thyroid carcinoma Thyroidectomy Central compartment dissection Extra thyroidal extension Tracheo-esophageal groove 


Compliance with ethical standards

Conflict of interest

No potential conflicts of interest to disclose for any author.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Department of Head and Neck Surgical OncologyHomi Bhabha National Institute, Tata Memorial HospitalParelIndia
  2. 2.Division of Neurosurgery, Department of Surgical OncologyHomi Bhabha National Institute, Tata Memorial HospitalMumbaiIndia

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