Thyroid lobe size predicts risk of postoperative temporary recurrent laryngeal nerve paralysis

Nobuyoshi Tsuzuki, Koichiro Wasano, Taiji Kawasaki, Shun ichi Sasaki, Kaoru Ogawa

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Objectives: In patients who had undergone thyroidectomy in Japan for benign tumor, we determined whether thyroid lobe size correlates with temporary recurrent laryngeal nerve paralysis (T-RLNP). Methods: We retrospectively collected medical record data on usage of intraoperative neuromonitoring, laterality of thyroidectomy, amount of bleeding during surgery, duration of surgery, and whether the surgeon was a board certified otorhinolaryngologist as determined by the Oto-Rhino-Laryngological Society of Japan. Thyroid size was measured in preoperative axial computed tomography (CT) images. Receiver operating characteristic (ROC) curve analysis was used to determine the thyroid size that predicted a high risk of T-RLNP or permanent recurrent laryngeal nerve paralysis (P-RLNP). Results: Of the 146 eligible patients identified, 9 (6.2%) developed T-RLNP and 2 (1.4%) developed P-RLNP. The amount of bleeding during thyroidectomy was significantly greater in T-RLNP patients than in P-RLNP patients. Thyroid sizes in CT images were significantly larger in T-RLNP patients compared to patients who did not develop RLNP (referred to hereafter as N-RLNP). ROC analysis revealed that 1.3% of thyroid lobes with an area of less than 1000.0 mm2, and 9.9% of thyroid lobes with an area of greater than 1000.0 mm2 were at risk for T-RLNP. Conclusion: We presented evidence that thyroid sizes, as measured on preoperative axial CT images, were larger in T-RLNP patients than in N-RLNP patients. Our results indicate a connection between benign thyroid tumor stretch injuries and T-RLNP. Level of Evidence: IV.

Original languageEnglish
Pages (from-to)708-713
Number of pages6
JournalLaryngoscope investigative otolaryngology
Issue number6
Publication statusPublished - 2019 Dec 1
Externally publishedYes


  • benign
  • recurrent laryngeal nerve
  • thyroid
  • thyroidectomy
  • vocal cord paralysis

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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