Incidence of Superior Laryngeal Nerve Injury during TotalThyroidectomy

Résumé

Introduction: Superior laryngeal nerve (SLN) injury is a significant complication of total thyroidectomy, affecting vocal quality and postoperative outcomes. This study aimed to evaluate the incidence of SLN injury, its associated risk factors, and outcomes in a resource-limited setting. Methods & Materials: A retrospective analysis was conducted on 100 patients who underwent total thyroidectomy for benign or malignant thyroid conditions. Preoperative and postoperative vocal assessments were performed using indirect laryngoscopy, and SLN injury was categorized as transient or permanent. Data on patient demographics, surgical indications, SLN identification, and surgeon experience were analyzed. Results: SLN injury occurred in 15.0% of patients, with 10.0% experiencing transient and 5.0% permanent injury. SLN identification was achieved in 70.0% of cases, with statistically significant outcomes (p = 0.010). Surgeons with over 10 years of experience demonstrated the lowest injury rates (5.9% permanent). Vocal cord mobility was impaired in 10.0% of cases postoperatively (p = 0.040). Most patients (90.0%) achieved full postoperative recovery, while 8.0% experienced partial recovery, and 2.0% showed no recovery. Conclusion: SLN injury remains a significant concern in total thyroidectomy, with outcomes strongly influenced by systematic nerve identification and surgeon expertise. Enhanced training and adoption of intraoperative nerve monitoring can minimize complications and improve postoperative recovery, particularly in resource-limited settings.