The Clinical Research Of The Recurrent Laryngeal Nerve Dissection Under The Microscope In Thyroid Surgery

Objective:In order to explore the clinical application and the necessity of the recurrent laryngeal nerve dissection under the microscope.A comparative study was used in this research (the recurrent laryngeal nerve dissection in a conventional method VS.dissection under the microscope).In this way,we try to improve the safety of thyroid surgery and reduce the rate of recurrent laryngeal nerve(RLN) injuryMethods:From March2011to March2013,we retrospectively analyzed clinical data of1080patients of thyroid operation in our hospital.All patients were divided into two groups(A:the recurrent laryngeal nerve dissection in a conventional method VS.B:dissection under the microscope).The patients of the recurrent laryngeal nerve dissection in a conventional method was856,while the dissection under the microscope was224.The rate of recurrent laryngeal nerve injury between the two groups were compared..After operation the fiber laryngoscope was used to determine whether the recurrent laryngeal had damaged.The anatomical location and the branches of the recurrent laryngeal nerve were studied under the microscope,as well as the anatomical relationship between the recurrent laryngeal nerve and the inferior thyroid artery(ITA) Results:1080patients were included in this research. The number of recurrent laryngeal nerve dissection in conventional method is1171.The number of left recurrent laryngeal nerve dissection was558,while the right dissection was613,The number of recurrent laryngeal nerve injury was15(left3VS.right12, P=0.032<0.05).The number of recurrent laryngeal nerve dissection under the microscope is380.The number of left recurrent laryngeal nerve dissection was189,while the right dissection was190, a number of non-recurrent laryngeal nerve(NRLN) in right side was found in the surgery,the value of P between the two groups was0.029(P=0.029<0.05)..The obvious variations of recurrent laryngeal nerve in right side than the left side were showed in this research.Conclusion:Research showed that the recurrent laryngeal nerve dissection under the microscope not only can clearly distinguish the anatomical location of the recurrent laryngeal nerve, the branches of the recurrent laryngeal nerve and the anatomical relationship between the recurrent laryngeal nerve and the inferior thyroid artery,but also can effectively reduce the injury rate of the recurrent laryngeal nerve in thyroidectomy.Which is a effective and reliable way to avoid the recurrent laryngeal nerve injury in thyroidectomy.