{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:59:51Z","timestamp":1777953591780,"version":"3.51.4"},"reference-count":61,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Oncology"],"abstract":"<jats:p>Background: Recurrent laryngeal nerve (RLN) palsy (RLNP) is not uncommon after thyroid surgery and can be debilitating. This is a retrospective cohort analysis of outcomes in patients with RLNP post-thyroidectomy for differentiated thyroid malignancy. Method: Clinicopathological details as well as outcomes of thyroidectomies for differentiated thyroid cancer in 862 patients performed over a period of 22 years (2001\u20132023) for nerve palsy were collected. The patients were stratified into two groups based on whether the RLN was amputated or preserved. Results: Of the 1,520 nerves in 862 patients at risk during thyroidectomy, a total of 71 (8.2%) (20 M:51 F) patients, with a median age of 54 (range: 19\u201383), suffered RLNP, which was temporary in 14 (1.6%), unilateral in 51 (5.9%), and bilateral in 6 (0.7%) patients. The RLN was amputated in 31 of 62 patients (50%). In 29 of 71 (41%) patients, the nerve was intentionally sacrificed due to gross disease infiltration while the RLN was inadvertently severed during dissection in 2 (3%) patients. Among cases with RLN transection, only five underwent primary repair or ansa cervicalis to RLN anastomosis. The only factor associated with amputation of the RLN was a larger tumour size (40.4 vs. 24.7 mm, p = 0.007). Preservation of voice quality was higher in the shave group in comparison to the amputation group (93.5% vs. 71.0%, p = 0.0426). Conclusion: Preservation of nerve or reconstruction in transectional injuries should be considered where possible to improve voice outcomes except in cases when the laryngotracheal complex is involved.<\/jats:p>","DOI":"10.1159\/000548260","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T16:00:46Z","timestamp":1756828846000},"page":"528-537","source":"Crossref","is-referenced-by-count":0,"title":["Managing the Involved Recurrent Laryngeal Nerve in Thyroid Cancer"],"prefix":"10.1159","volume":"104","author":[{"given":"Tse Kiat","family":"Soong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Shuyun","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi Xun","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ngiam 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