dc.contributor.author | Wahome, J N | |
dc.date.accessioned | 2013-05-23T06:45:35Z | |
dc.date.available | 2013-05-23T06:45:35Z | |
dc.date.issued | 2007 | |
dc.identifier.citation | master of medicine | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/24601 | |
dc.description.abstract | Iatrogenic injury of recurrent laryngeal nerve (RLN) is one of the most
serious concerns in thyroid surgery. I carried out a prospective study aimed at
determining the prevalence of RLN paralysis, its presentation and the associated
risk factors among patients undergoing thyroidectomy at Kenyatta National
hospital (KNH), Nairobi, Kenya.
Methods
All patients had indirect laryngoscopy (IL) done one day before operation
to assess the integrity of the RLN s through vocal cords function. Patients with
RLN paralysis prior to surgery were excluded from the study. Symptoms occurring
one day after surgery were noted down. This was repeated at around six weeks
post-operation and patients presenting with symptoms suggestive of RLN paralysis
had a second IL done. Correlation between the occurrence of paralysis and the age,
sex, histopathological process, type of operation done, surgeon's experience and
intra-operative RLN identification was done.
Results
Seventy-one (88.8%) had benign thyroid disease while 9 (11.2%) had cancer
ofthyroid. Seven patients (8.8%) were found to have developed RLN paralysis
with the majority (57.1 %) having suffered left adductor paralysis. Re-operation for
recurrent malignancy had the highest rate of paralysis (40%) while primary
operations in general (5.6%) and primary operations for benign disease (5.9%) had
the lowest rates. Three patients (42.9%) presented with hoarseness alone, 3
(42.9%) with hoarseness and aspiration while 1 (14.2%) had dyspnoea.
Conclusions
Thyroidectomy is an important etiological factor to developing RLN
paralysis at KNH. Re-operations on the thyroid and failure to identify the RLN
intra-operatively are significant risk factors to developing RLN paralysis. The
majority of patients who develop RLN paralysis following thyroidectomy at KNH
present with hoarseness. | en |
dc.description.sponsorship | University of Nairobi | en |
dc.language.iso | en | en |
dc.title | Ear,nose and throat - head and neck surgery | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | Department of surgery, University of Nairobi. | en |