OPERATIVE TREATMENT OF THE RECURRENT GOIT ER WITH PREEXISTING UNILATERAL RECURRENT NERVE PALSY - A REPORT OF PERSONAL EXPERIENCES

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.