[Surgical prophylactics of injuries of the recurrent laryngeal nerves during operations for diseases of the thyroid gland].

The work presents an analysis of specific features of surgical anatomy of recurrent laryngeal nerves in 676 patients operated in the City Center of endocrine surgery and oncology of St. Petersburg for different diseases of the thyroid gland (TG) during the period from 01.01.2005 to 15.07.2006 mainly by one and the same surgeon. In the course of 696 operations 718 recurrent laryngeal nerves were detected, verified, separated in the neck from the subclavian area to the place of entering into the larynx, and photo-video documented. In 656 cases the disease of TG was primary, and in 40 cases--recurrent. The investigation performed allowed the development and use of reliable methods of prophylactics and treatment of recurrent laryngeal nerves injured in patients during operations for different diseases of TG, carcinoma of this organ included. The optimal places of detection and identification were determined as well as the ways of separation of these nerves from the surrounding tissues. The surgical anatomy of the recurrent laryngeal nerves in the neck was studied. The role, place and effectiveness of electrophysiological monitoring were established. The corrections introduced in the technique of thyroidectomies in 4110 patients resulted in lowered incidence of postoperative pareses of the laryngeal muscles from 0.91% to 0.56% during the period from 2001 to 2006.