Clinical classification of recurrent laryngeal nerve palsy
Chisato Tomoda, Kana Yoshioka, Yoshiyuki Saito, Chie Masaki, Junko Akaishi, Kiyomi Y. Hames, Ritsuko Okamura, Akifumi Suzuki, Kenichi Matsuzu, Wataru Kitagawa, Kiminori Sugino, Koichi Ito
Abstract
Background: The application of intraoperative neurophysiological monitoring (IONM) has been accepted to avoid injury of a recurrent laryngeal nerve (RLN). Loss of the neuromonitoring signal indicates nerve injury and is subdivided into segmental type and global type nerve paralysis. This study aimed to determine the course of vocal cord function recovery after definitive loss of signal (LOS) types. Methods: This retrospective study included 1,442 patients (with 2,752 nerves at risk) who had thyroidectomies between January 2018 and December 2021. Preoperative and postoperative vocal cord functions were evaluated by laryngoscopic examination. Results: . global 3.4%) (P<0.001). Conclusions: The intraoperative recovery rate and early nerve recovery rate are significantly higher for patients with global LOS than for patients with segmental LOS. Cancer patients with segmental LOS significantly more often had vocal cord dysfunction than those with global LOS at 6 months postoperatively.