Clinic Research Of Protecting Parathyroid Glands And Laryngeal Recurrent Nerves In The Thyroid Reoperation

Objective:To explore the effective methods of reservingparathyroid gland and avoiding recurrent laryngeal nerve injury duringthyroid reoperation.Methods: Retrospective analysis of the clinical datas of341patientswho had undergone the second thyroid from January2008to January2013.Results: In the341cases of thyroid reoperation，30cases hadrecurrent laryngeal nerve injury,25cases had hypoparathyroidism,2caseshad superior laryngeal nerve injury.Conclusions: It is easy to damage recurrent laryngeal nerve andparathyroid gland,the key to protect recurrent laryngeal nerve andparathyroid gland is to identify them in operation.We should try our bestto protect the blood supply of the parathyroid gland,especially whenseparating the dorsal side of upper and lower poles.And the suspicioustissue section should be sent to do quick frozen section examination.If the tissue was confirmed to be parathyroid gland,it should be cut into1.0mm*1.0mm granules,and transplant these granules to the muscles inneck or antebrachium.In thyroid reoperation,exposure of recurrentlaryngeal nerve can reduce the chance to damage recurrent laryngealnerve,expecially in reoperation of thyroid cancer,exposure of recurrentlaryngeal nerve is a positive difference in preventing recurrent laryngealnerve injury.But for recurrence of benign thyroid disease,because of theobscure anatomical structure and the severe tissue adhesion,morehaemorrhage is easy to happen and the blood supply of parathyroid glandis likely to be influenced,thus leading to hypocalcemia.For thesepatients,if the thyroid capsule and the dorsal tissues of thyroid gland canbe completely reserved,there is no need to expose the nerves.