Type of publication:
*Fussey J.; *El-Shunnar S.; *Spinou C.; *Hughes R.; *Ahsan F.
European Journal of Surgical Oncology; Dec 2017; vol. 43 (no. 12); p. 2388-2389
It is generally accepted that central compartment neck dissection (CCND) improves locoregional recurrence rates in cases of known central compartment lymph node involvement, however the practice of prophylactic CCND is somewhat more controversial. It is often quoted anecdotally that the risk of damage to the recurrent laryngeal nerve is higher during CND than in thyroidectomy only. The aim of this study was to evaluate recurrent laryngeal nerve injury rates following CND in thyroid cancer patients. Prospectively collected data from three head and neck cancer centres was retrospectively analysed to identify patients who underwent CND with or without concurrent thyroid surgery over a three-year period. Fifty-eight patients underwent CND, 35 of which were bilateral. There were therefore 92 recurrent laryngeal nerves at risk. The temporary recurrent laryngeal nerve palsy rate was 2.2%, and the permanent palsy rate was 3.3%. All cases of permanent recurrent laryngeal palsy occurred in patients undergoing CND and total thyroidectomy for pT4 disease. Many factors can affect recurrent laryngeal nerve palsy rate following CND, including surgeon experience, tumour characteristics and extent of dissection. Our experience suggests that the risk to the nerve in CND is no higher than in standard thyroid surgery.