Kosin Med J.  2024 Jun;39(2):94-98. 10.7180/kmj.24.117.

Surgical management of recurrent laryngeal nerve invasion by papillary thyroid carcinoma

• Park JH
• Lee HS

• KMID: 2556806
• DOI: http://doi.org/10.7180/kmj.24.117

Abstract

Preservation of the recurrent laryngeal nerve (RLN) is a priority for surgeons during thyroidectomy in patients with papillary thyroid cancer (PTC). RLN invasion by PTC in a patient presenting with preoperative vocal fold paralysis may require resection of the nerve with the tumor. However, the decision should be made regarding whether to preserve or sacrifice a functioning RLN invaded by PTC. Under certain conditions, preservation of the nerve with incomplete tumor resection could be considered. An RLN that has been resected due to PTC invasion may be managed by various reinnervation techniques to improve vocal outcomes. This article reviews clinical considerations and rationales for surgical decisions related to patients with PTC invasion of the RLN.

Keyword

Neuromuscular monitoring; Recurrent laryngeal nerve; Thyroid neoplasms; Thyroidectomy

Figure

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  Fig. 1. Ultrasound image of a patient with suspected invasion of the recurrent laryngeal nerve by a papillary thyroid carcinoma. Protrusion of the tumor into the right tracheoesophageal groove and partial loss of normal thyroid tissue between cancer and the tracheoesophageal groove can be seen. The photograph was provided by the author, Hyoung Shin Lee.

Reference

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