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KMID : 1202020080010020148
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Journal of Korean Thyroid Association
2008 Volume.1 No. 2 p.148 ~ p.153
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Preservation of Invaded Recurrent Laryngeal Nerve in Patients with Papillary Thyroid Cancer with Normal Vocal Cord Function: Functional and Oncological Results
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Kim Young-Rok
Kim Ju-Yeon
Kim Sung-Won
Lee Bong-Ju
Cha Yong-Woo
Lee Kang-Dae
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Abstract
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Background and Objectives: Complete excision with resection of the recurrent laryngeal nerve (RLN) in differentiated papillary thyroid carcinoma (PTC) with invasion of RLN, reportedly did not improve the survival over incomplete excision. However some investigators have provided definitive oncologic and functional outcomes concerning the preservation of recurrent laryngeal nerve involved in thyroid cancer.
Materials and Methods: The RLN involved by locally invasive papillary thyroid carcinoma was preserved in 15 patients with functioning vocal cord, between April 1998 and April 2004. Retrospective study was performed with medical records of 11 patients who were followed-up more than 48 months. All patients were treated by the shaving technique for RLN preservation. Postoperative radioiodine and thyroid stimulating hormone suppression therapy were combined for ablation of microscopic residual PTC.
Results: Postoperative survival rate of the patients with RLN preservation was 100%, and local recurrence was not observed. There were 13 nerves showing infiltration by PTC during the operation. Permanent vocal cord paralysis was not observed and transient vocal cord paralysis occurred in 1 nerve (7.7%) of 1 patient.
Conclusion: Although the number of patients and follow-up duration of the study may be limited, preservation of RLN infiltrated by PTC maintained the functioning vocal cord without any clinical recurrence.
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KEYWORD
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Papillary carcinoma, Recurrent Laryngeal Nerve, Local invasion
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