Mazhar Iqbal, Sughra Parveen.
Recurrent Laryngeal Nerve Palsy and Hypocalcemia with and without Bilateral Ligation of Inferior Thyroid Artery in Total Thyroidectomy.
J Surg Pak Jan ;20(1):19-22.

Objective: To find out frequency of recurrent laryngeal nerve palsy and hypocalcemia with and without bilateral ligation of inferior thyroid artery (ITA) in total thyroidectomy. Study design: Descriptive case series. Place & Duration of study: Department of General Surgery ward 3, Jinnah Postgraduate Medical Center Karachi, from April 2010 to April 2015. Methodology: All patients of non toxic multimodular goitre who had indication for surgery were included. Patients were divided in two groups. In group I patients ITA was ligated and in group II it was left alone during total thyroidectomy. Postoperatively serum calcium level was done after 24 hours, 48 hours and on Day 7. Voice changes were also noted. If hypocalcemia and voice changes recovered within 6 months then the condition was labeled as transient phenomenon. If changes persisted then it was considered permanent insult. Results: There were 100 patients of non toxic multimodular goitre in this series. Age range was from 12 year to 65 year. In each group there were 48 females and 2 males. In group I 12(24%) patients developed transient hypocalcemia and 3(6%) had transient recurrent laryngeal nerve palsy. In group II 10(20%) developed hypocalcemia and 7(14%) had recurrent laryngeal nerve palsy. All were transient in nature. Conclusion: The frequency of hypocalcemia and recurrent laryngeal palsy was less in patents with bilateral ITA ligation.

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