Recurrent laryngeal nerve injury after thyroidectomy: A national study from Saudi Arabia.

OBJECTIVES: To determine the incidence and possible risk factors of recurrent laryngeal nerve injury, to provide a relevant literature review of studies from other centers in Saudi Arabia, and to present basic statistical data for future studies in our local community. METHODS: A retrospective study enrolled patients who were surgically treated for thyroid disease between January 2015 and December 2021. For concerns during the procedure, direct laryngoscopy was carried out before extubation to assess the vocal cords. Similarly, indirect laryngoscopy was carried out for patients who developed postoperative voice changes. All patients were evaluated clinically 2-3 weeks after surgery. Nerve monitors were not used in either case. RESULTS: The study examined 437 participants: 361 (82.6%) female and 76 (17.4%) male individuals. The incidence of recurrent laryngeal nerve injury was 1.1%. The demographic characteristics, pathology (benign vs. malignant), and extent of thyroidectomy were not significantly associated with the risk of recurrent laryngeal nerve injury. CONCLUSION: A recurrent laryngeal nerve injury is a serious complication, and further studies are required to determine the safest techniques for thyroidectomy. However, centralization of thyroid surgery in high-volume centers might reduce this risk.

Post-Thyroidectomy Hematoma: Risk Factors To Be Considered for Ambulatory Thyroidectomy.

INTRODUCTION: Post-thyroidectomy hematoma is a serious, potentially life-threatening complication and it is the most frequent indication for reoperation. In this study, we aimed to identify the risk factors and prevalence of post-thyroidectomy hematoma and perform a literature review of the incidence of post-thyroidectomy hematoma at other centers in Saudi Arabia. METHODS: We retrospectively enrolled 372 consecutive patients who had undergone thyroidectomy between January 2015 and December 2020. Patients with bleeding disorders were excluded from the study. Data were analyzed using SPSS software, version 20.0 (IBM Corp., Armonk, NY). RESULTS: Three female (0.8%) patients developed a hematoma after thyroidectomy. Two patients developed a hematoma 24 hours after surgery and were treated conservatively. The third patient developed a hematoma within two hours of surgery and required surgical intervention. None of the patients required a tracheostomy, and there was no mortality. No significant association was found between age, sex, final pathology, the extent of thyroidectomy, and risk of hematoma. CONCLUSION: A post-thyroidectomy hematoma is a rare but dangerous complication. Identifying the risk factors for hematoma formation is of great importance, particularly when considering outpatient thyroidectomy. A large prospective multicenter study is needed for further investigation.