Testa Domenico, Del Vecchio Lucia, Motta Sergio, Castagna Ludovica, Conzo Giovanni, Carandente Vincenza, Docimo Giovanni, Lombardo Nicola, Conzo Alessandra, Motta Giovanni, Docimo Ludovico
Department of Mental Health and Public Medicine, Otorhinolaryngology-Head and Neck Surgery Unit University of Campania L. Vanvitelli Naples Italy.
Department of Neurosciences, Reproductive and Odontostomatologic Sciences, Unit of Ear, Nose and Throat "Federico II" University Naples Italy.
World J Otorhinolaryngol Head Neck Surg. 2024 Aug 21;11(2):256-263. doi: 10.1002/wjo2.203. eCollection 2025 Jun.
Bilateral recurrent nerve damage still represents one of the main complications following thyroid surgery, even though the nerve intraoperative monitoring has allowed the decrease of this injury This observational retrospective study aims to define the onset modalities and the recovery time of different clinical conditions that may occurs after thyroidectomy.
From a total of 1417 patients who underwent total thyroidectomy for benign tumors between 2017 and 2022 in ENT Unit of University of Campania "L. Vanvitelli," this study involved 30 patients with bilateral vocal folds motility deficit. These patients (28 F, 2 M), aged from 24 to 78 years old (average age 51.7), presented a bilateral vocal fold motility deficit. Five patients of the study developed an acute respiratory failure upon the awakening that required a nasotracheal prolonged safe extubation. The other 25 patients underwent 9 months diagnostic and therapeutic process, which started approximately 30 days after thyroid surgery.
Indeed, there are several outcomes of these complications, like functional laryngeal defects, which are mainly related to respiratory and phonatory activities. These clinical manifestations can evolve in different ways within a context of a wide range of possibilities, from the spontaneous bilateral or monolateral recovery to the necessity of a functional or surgical restoration.
This study allowed the acquisition of useful information about prognostic indications and an adequate therapeutic process, based on the specific clinical characteristics.
双侧喉返神经损伤仍是甲状腺手术后的主要并发症之一，尽管神经术中监测已使这种损伤有所减少。本观察性回顾性研究旨在确定甲状腺切除术后可能出现的不同临床情况的发病方式和恢复时间。
在坎帕尼亚大学“L. 万维泰利”耳鼻喉科2017年至2022年期间接受甲状腺全切除术治疗良性肿瘤的1417例患者中，本研究纳入了30例双侧声带运动功能障碍患者。这些患者（28名女性，2名男性）年龄在24至78岁之间（平均年龄51.7岁），均存在双侧声带运动功能障碍。研究中有5例患者术后苏醒时出现急性呼吸衰竭，需要进行长时间的经鼻气管安全拔管。其他25例患者在甲状腺手术后约30天开始了为期9个月的诊断和治疗过程。
事实上，这些并发症有多种结局，如功能性喉部缺陷，主要与呼吸和发声活动有关。这些临床表现可能在多种可能性的背景下以不同方式演变，从自发的双侧或单侧恢复到功能性或手术修复的必要性。
本研究基于特定临床特征，获取了有关预后指标和适当治疗过程的有用信息。
