Risk factors for Recurrent Laryngeal Nerve Palsy in the immediate post- thyroidectomy period at a tertiary care centre - a retrospective cohort study

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Background: Recurrent laryngeal nerve palsy (RLNP) is a frequent and potentially serious complication of thyroid surgery. Various risk factors can predict the likelihood of this complication so that careful anticipation in high risk cases can help in reducing the incidence. In this study we explored the factors associated with RLNP during thyroid surgery in a tertiary care setting. \nMaterials and methods: 850 patients who underwent thyroidectomy in our institution were studied retrospectively (2017-2018). Baseline and other operative factors associated with RLNP in the immediate post-operative period were analysed using univariate and multivariate methods. \nResults: RLNP occurred in 6.7% of the 850 patients included in the study. After multivariate adjustment, RLNP was independently associated with increasing age, retrosternal extension and total thyroidectomy with neck dissection. Though male gender, previous neck surgery, total thyroidectomy and near total thyroidectomy showed increased risk of RLNP, the risk was not significant. \nConclusions: Increasing age, retrosternal extension and total thyroidectomy with neck dissection showed a significantly increased risk of RLNP in the immediate post thyroidectomy period in this series of 850 patients.

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