{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:19:36Z","timestamp":1788877176471,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,2,3]],"date-time":"2015-02-03T00:00:00Z","timestamp":1422921600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2017,5]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Bilateral recurrent laryngeal nerve (RLN<\/jats:styled-content>) palsy following total thyroidectomy is a rare complication, however, poses significant morbidity to the patient when it does occur. The purpose of this paper was to determine the incidence of bilateral RLN<\/jats:styled-content> palsy in a specialized thyroid unit and determine whether the routine use of intraoperative nerve monitoring (IONM<\/jats:styled-content>) would alter the outcome.<\/jats:p><\/jats:sec>Methods<\/jats:title>This is a retrospective review of prospectively gathered data. A total of 7406 patients underwent total thyroidectomy at the University of Sydney Endocrine Surgical Unit between January 1990 and February 2014. IONM<\/jats:styled-content> was utilized on a selective basis and we sought to assess whether IONM<\/jats:styled-content> would have altered outcome in those patients who developed bilateral RLN<\/jats:styled-content> palsy.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 7406 patients who underwent total thyroidectomy, seven patients (0.09%) developed bilateral RLN<\/jats:styled-content> palsy during the study period. There was one permanent RLN<\/jats:styled-content> palsy (0.01%) and routine IONM<\/jats:styled-content> may have prevented one death and altered the outcome in two of the seven patients.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Bilateral RLN<\/jats:styled-content> palsy is a rare entity occurring in one out of 1000 cases in a specialized thyroid unit. IONM<\/jats:styled-content> may facilitate the decision to pursue delayed surgery where the signal is lost on the first surgical side and has the potential to avoid bilateral RLN<\/jats:styled-content> palsy following total thyroidectomy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.12980","type":"journal-article","created":{"date-parts":[[2015,2,4]],"date-time":"2015-02-04T02:36:20Z","timestamp":1423017380000},"page":"364-367","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Bilateral recurrent laryngeal nerve injury in a specialized thyroid surgery unit: would routine intraoperative neuromonitoring alter outcomes?"],"prefix":"10.1111","volume":"87","author":[{"given":"Leba M.","family":"Sarkis","sequence":"first","affiliation":[{"name":"Endocrine Surgical Unit Royal North Shore Hospital The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisar","family":"Zaidi","sequence":"additional","affiliation":[{"name":"Endocrine Surgical Unit Royal North Shore Hospital The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olov","family":"Norl\u00e9n","sequence":"additional","affiliation":[{"name":"Endocrine Surgical Unit Royal North Shore Hospital The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh W.","family":"Delbridge","sequence":"additional","affiliation":[{"name":"Endocrine Surgical Unit Royal North Shore Hospital The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"Sywak","sequence":"additional","affiliation":[{"name":"Endocrine Surgical Unit Royal North Shore Hospital The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stan B.","family":"Sidhu","sequence":"additional","affiliation":[{"name":"Endocrine Surgical Unit Royal North Shore Hospital The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6417"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2008.01875.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.135.2.204"},{"key":"e_1_2_6_5_1","first-page":"101","article-title":"Prevention and treatment of recurrent laryngeal nerve injury in thyroid surgery","volume":"7","author":"Jiang Y","year":"2014","journal-title":"Int. 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