Modern approaches to treatment of recurrent laryngeal nerve injuries after thyroidectomy

Introduction. Intraoperative neuromonitoring in modern surgical intervention on the thyroid gland, there is a certain risk of postoperative complications. Intraoperative injury to the recurrent laryngeal nerve (RLN) continues to be one of the most common and leads to a decrease in the quality of life of patients and loss of professional activity.
The purpose of the study. To study modern conservative and surgical methods of treating intraoperative injury to the recurrent laryngeal nerve in surgical treatment of thyroid diseases.
Materials and methods of research. A review of data in PubMed, ScienceDirect, eLIBRARY was performed. Exclusion criteria for the analysis: descriptions of individual clinical cases; books and documents. Of the initially identified 108 sources, 46 were included in the review.
Treatment results. The highest efficiency among the options for drug therapy of intraoperative injury of the RLN is demonstrated by the administration of neuromedin, proserin, nimodipine and dexamethasone. Among the methods of surgical treatment of RLN injuries, microsurgical plastic surgery of damaged vocal cords, percutaneous or endoscopic injection laryngoplasty and medializing thyroplasty are used.
Conclusion. Drug treatment of RLN injuries is effective in 65-88% of cases, surgical treatment – in 78–94 %. Conservative methods of treatment require long-term use, which leads to a gradual restoration of the RLN function. Despite the high efficiency of surgical methods, there is a high risk of complications in the postoperative period, which requires careful selection of patients and an assessment of the degree of risk of surgical intervention and its absence.

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