J. Wasiak et T. Pohle, OPERATIVE TREATMENT OF THE RECURRENT GOIT ER WITH PREEXISTING UNILATERAL RECURRENT NERVE PALSY - A REPORT OF PERSONAL EXPERIENCES, Zentralblatt fur Chirurgie, 121(7), 1996, pp. 584-586
Operations for recurrent goiter are considered to range among the most
difficult procedures in thyroid surgery, because the risk of a perman
ent recurrent nerve palsy increases to 10 or 30%. In case of pre-exist
ing unilateral lesion of the nerve the danger of bilateral paralysis o
f the vocal chord will become even larger. The results from 29 patient
s with an intracapsular resection (nearly total removement of the thyr
oid tissue without the preparation of the recurrent nerve) are present
ed and compared with those found in 4 patients with an extracapsular a
pproach. All four patients, where the operation was performed extracap
sularly, must he tracheotomized although the palsy did recover within
21 days till 14 months. After an intracapsular resection of the recurr
ence at the side of an intact nerve (29 patients) a tracheotomy had no
t been necessary.