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

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Abstract

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.

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Acknowledgments

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.

Author information

Authors and Affiliations

  1. Department of ENT Head and Neck Surgery, Odense University Hospital, 5000, Odense C, Denmark

    Christian Godballe & Anders Rørbæk Madsen

  2. Department of ENT Head and Neck Surgery, Gentofte Hospital, Hellerup, Denmark

    Christian Hjort Sørensen

  3. Department of ENT Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark

    Sten Schytte

  4. Department of ENT Head and Neck Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    Waldemar Trolle

  5. Department of ENT Head and Neck Surgery, Vejle Hospital, Vejle, Denmark

    Jens Helweg-Larsen

  6. Department of ENT Head and Neck Surgery, Slagelse Hospital, Slagelse, Denmark

    Lisa Barfoed

  7. Department of ENT Head and Neck Surgery, Viborg Hospital, Viborg, Denmark

    Larry Kristiansen

  8. Department of ENT Head and Neck Surgery, Køge Hospital, Køge, Denmark

    Vibeke Zederkof Sørensen

  9. Department of ENT Head and Neck Surgery, Hillerød Hospital, Hillerød, Denmark

    Grethe Samuelsen

  10. Department of ENT Head and Neck Surgery, Aalborg University Hospital, Aalborg, Denmark

    Henrik Baymler Pedersen

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  1. Christian Godballe
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  2. Anders Rørbæk Madsen
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  3. Christian Hjort Sørensen
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  6. Jens Helweg-Larsen
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  7. Lisa Barfoed
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  8. Larry Kristiansen
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  9. Vibeke Zederkof Sørensen
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  10. Grethe Samuelsen
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  11. Henrik Baymler Pedersen
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Corresponding author

Correspondence to Christian Godballe.

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Godballe, C., Madsen, A.R., Sørensen, C.H. et al. Risk factors for recurrent nerve palsy after thyroid surgery: a national study of patients treated at Danish departments of ENT Head and Neck Surgery. Eur Arch Otorhinolaryngol 271, 2267–2276 (2014). https://doi.org/10.1007/s00405-013-2767-7

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  • DOI: https://doi.org/10.1007/s00405-013-2767-7

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