Introduction: Injury to recurrent laryngeal nerve (RLN) is significant complication after thyroid surgery that leads to voice changes, aspiration, breathing difficulty if both nerves are injured and impairment in quality of life. The aim of this study was to find the prevalence of recurrent laryngeal nerve palsy following thyroid surgery. Methods: It was a observational study carried out in the department of ENT-Head and Neck Surgery of Maharajgunj Medical Campus and TU Teaching Hospital, Institute of Medicine (IOM). The surgery records between January 2013 and April 2025 were reviewed to document demographic information, type of surgery, paralysis of RLN and its recovery rate at least six months following surgery. The data were recorded in the excel sheet version 16 and percentages, rate, ratio and mean were calculated. The ethical clearance for the study was obtained from institutional review committee (IRC) of IOM (Ref 538 (6-11) E2/081/082). Results: A total of 695 patients underwent thyroid surgery. Recurrent laryngeal nerve palsy occurred in 53 (7.62%) patients and in 66 (6.96%) nerves. The incidence was higher in malignant disease and in patients undergoing thyroid surgery with neck dissection. Unilateral palsy was observed in 40 (5.75%) patients and bilateral palsy in 13 (1.87%) patients, with no requirement for airway intervention. On follow-up, recovery was seen in 38 (70.37%) nerves, while 16 (29.63%) nerves developed permanent palsy. Conclusions: Recurrent laryngeal nerve palsy remains a significant complication of thyroid surgery, particularly in malignant disease and extensive procedures, with most cases showing recovery on follow-up.
Tripathi et al. (Sat,) studied this question.