Repeat surgery for thyroid nodules (excluding cancer and hyperthyroidism).

Second procedures for recurrent thyroid disease are known to carry a high r isk of iatrogenic damage, particularly to the inferior laryngeal nerves and parathyroid glands. This risk has been clearly evaluated for the primary p rocedure, but is less clearly for second procedures. A series of 117 patien ts with solitary or multiple cold thyroid nodules were evaluated (excluding those patients re-operated for recurrent thyroid carcinoma or goitre assoc iated with hyperthyroidism) to determine the operative risks, The level of transient and permanent recurrent laryngeal nerve palsy was 2.56 % and 1.7 % respectively. The level of transient and permanent hypocalcaemia was 12.9 % and 4.62 % respectively. The frequency of re-operation for recurrent dis ease involving the pyramidal lobe following total thyroidectomy (6 cases) h ighlights the importance of removing it during the primary procedure. The n umber of cases of cancer discovered at reoperation was 4.3 % (5 cases out o f 117).