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The Efficacy of Intraoperative Corticosteroids in Recurrent Laryngeal Nerve Palsy after Thyroid Surgery

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Abstract

Background

Recurrent laryngeal nerve palsy (RLNP) is one of the most common complications after thyroidectomy. We aim to evaluate the role of intraoperative corticosteroids in preventing or treating postoperative RLNP.

Materials and Methods

We conducted a prospective study of 295 patients who underwent either total lobectomy or total thyroidectomy with or without using intraoperative corticosteroids. All cases were operated on by the same surgeon. Measurement of the RLNP rate was based on the number of nerves at risk. Data were analyzed for differences in postoperative temporary or permanent RLNP rate and recovery days.

Result

The rate of temporary/permanent RLNP was 5.7% (11 out of 194)/0.52% (1 out of 194) and 6.9% (12 out of 173)/0.58% (1 out of 173) according to groups with and without corticosteroids. This difference did not reach statistical significance. Among those 23 patients who recovered from RLNP, the mean time to recovery was significantly shorter for patients receiving intraoperative steroids (28.6 vs. 40.5 days, P = 0.045).

Conclusion

A single dose of intraoperative corticosteroids did not produce any benefit in terms of reducing the postoperative temporary/permanent RLNP rate, but it did shorten the recovery time for patients suffering from temporary RLNP.

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References

  1. Jones KJ, Drengler SM, Oblinger MM. Gonadal steroid regulation of growth-associated protein GAP-43 mRNA expression in axotomized hamster facial motor neurons. Neurochem Res 1997;22(11):1367–1374

    CAS  PubMed  Google Scholar 

  2. Bansberg SF, McCaffrey TV. The effect of systemic triamcinolone acetonide on nerve repair. Otolaryngol Head Neck Surg 1987;96(2):158–164

    CAS  PubMed  Google Scholar 

  3. Lipton R, McCaffrey TV, Ellis J. The beneficial effect of triamcinolone acetonide on nerve repair with autogenous grafts. Otolaryngol Head Neck Surg 1986;94(3):310–315

    CAS  PubMed  Google Scholar 

  4. Stankiewicz JA. A review of the published data on steroids and idiopathic facial paralysis. Otolaryngol Head Neck Surg 1987;97(5):481–486

    CAS  PubMed  Google Scholar 

  5. Austin JR, Peskind SP, Austin SG, et al. Idiopathic facial nerve paralysis: a randomized double blind controlled study of placebo versus prednisone. Laryngoscope 1993;103(12):1326–1333

    CAS  PubMed  Google Scholar 

  6. Lore JM Jr, Farrell M, Castillo NB. Endocrine surgery. In: Lore JM Jr, Medina JE (eds) An Atlas of Head and Neck Surgery, 4th edn. Elsevier, Philadelphia 2005:963–965

    Google Scholar 

  7. Harness JK, Fung L, Thompson NW, et al. Total thyroidectomy: complications and technique. World J Surg 1986;10(5):781–786

    CAS  PubMed  Google Scholar 

  8. Lore JM Jr. Practical anatomical considerations in thyroid tumor surgery. Arch Otolaryngol 1983;109(9):568–574

    PubMed  Google Scholar 

  9. Jatzko GR, Lisborg PH, Muller MG, et al. Recurrent nerve palsy after thyroid operations—principal nerve identification and a literature review. Surgery 1994;115(2):139–144

    CAS  PubMed  Google Scholar 

  10. Lo CY, Kwok KF, Yuen PW. A prospective evaluation of recurrent laryngeal nerve paralysis during thyroidectomy. Arch Surg 2000;135(2):204–207

    CAS  PubMed  Google Scholar 

  11. Liu Q, Djuricin G, Prinz RA. Total thyroidectomy for benign thyroid disease. Surgery 1998;123(1):2–7

    CAS  PubMed  Google Scholar 

  12. Chiang FY, Wang LF, Huang YF, et al. Recurrent laryngeal nerve palsy after thyroidectomy with routine identification of the recurrent laryngeal nerve. Surgery 2005;137(3):342–347

    Article  PubMed  Google Scholar 

  13. Wagner HE, Seiler C. Recurrent laryngeal nerve palsy after thyroid gland surgery. Br J Surg 1994;81(2):226–228

    CAS  PubMed  Google Scholar 

  14. Razack MS, Lore JM Jr, Lippes HA, et al. Total thyroidectomy for Graves’ disease. Head Neck 1997;19(5):378–383

    Article  CAS  PubMed  Google Scholar 

  15. Agarwal A, Mishra SK. Role of surgery in the management of Graves’ disease. J Indian Med Assoc 2001;99(5):252, 254–256

    CAS  PubMed  Google Scholar 

  16. Steurer M, Passler C, Denk DM, et al. Advantages of recurrent laryngeal nerve identification in thyroidectomy and parathyroidectomy and the importance of preoperative and postoperative laryngoscopic examination in more than 1000 nerves at risk. Laryngoscope 2002;112(1):124–133

    PubMed  Google Scholar 

  17. Flynn MB, Lyons KJ, Tarter JW, et al. Local complications after surgical resection for thyroid carcinoma. Am J Surg 1994;168(5):404–407

    CAS  PubMed  Google Scholar 

  18. Buchman CA, Fucci MJ, Slattery WH, et al. Intraoperative corticosteroids in acoustic tumor surgery. Am J Otol 1999;20(3):386–389

    CAS  PubMed  Google Scholar 

  19. Lee KJ, Fee WE Jr, Terris DJ. The efficacy of corticosteroids in postparotidectomy facial nerve paresis. Laryngoscope 2002;112(11):1958–1963

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung 807, Taiwan

    Ling-Feng Wang MD, Ka-Wo Lee MD, Wen-Rei Kuo MD, Che-Wei Wu MD & Feng-Yu Chiang MD

  2. Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung 807, Taiwan

    Ka-Wo Lee MD, Wen-Rei Kuo MD & Feng-Yu Chiang MD

  3. Department of Health, Executive Yuan, Tainan, Taiwan

    Shang-Pin Lu MD

Authors
  1. Ling-Feng Wang MD
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  2. Ka-Wo Lee MD
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  3. Wen-Rei Kuo MD
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  4. Che-Wei Wu MD
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  5. Shang-Pin Lu MD
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  6. Feng-Yu Chiang MD
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Correspondence to Feng-Yu Chiang MD.

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Wang, LF., Lee, KW., Kuo, WR. et al. The Efficacy of Intraoperative Corticosteroids in Recurrent Laryngeal Nerve Palsy after Thyroid Surgery. World J. Surg. 30, 299–303 (2006). https://doi.org/10.1007/s00268-005-0399-9

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  • DOI: https://doi.org/10.1007/s00268-005-0399-9

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