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https://doi.org/10.14300/mnnc.2016.11117

Microsurgical thyroidectomy in patients with multinodular goiter with nervous disorders of the larynx

[Original research] [Surgery]
Yuri Nazarochkin; Tamara Panova; Alexander Proskurin; Yuri Kuchin; Robert Mustafin;

The results of surgical treatment of 67 patients with a multinodular goiter were studied. The 15 patients with clinical signs of violations of voice function of a larynx (1 group) are operated, hemithyroidectomy with a resection of a counterlateral lobe (13) and thyroidectomy (2) with the use of intraoperative microscopy for a dissection of a posterior surface of a thyroid gland were performed. In a control group 19 patients without laryngeal dysfunctions are operated by a similar technique (the 2nd group). The subtotal thyroidectomy was done to 33 patients (the 3rd group). Unilateral persistent paresis of a larynx was absent in the 1 group, in the 2nd group – 5.3 %, in the 3rd group – 3 %, total – 3 %. Transition paresis of a larynx: in the 1 group – 6.7 %, in the 2nd group – 5.3 %, in the 3rd group – 6 %, total – 5.97 %. Disphonia is revealed at 13.4 % of the examined patients, in the 1 group – at 13.3 %, in the 2nd group – at 21 %, in the 3rd group – at 9 % of patients.

Improving the results of surgical treatment in multinodular goiter in our study are related to the technology of exposure of the posterior surface of the thyroid gland using a microscopy for the prevention of intraoperative laryngeal paresis.

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Keywords: multinodular euthyroid goiter, microscopy, thyroid gland, complications