OBJECTIVETo study the feasibility and therapeutic effect of recurrent laryngeal nerve (RLN) decompression in the treatment of bilateral paralyzed RLN after thyroid surgery.

METHODSFrom March 2005 to June 2013, 15 cases of bilateral RLN paralyses occurring within 3 months after thyroid surgery were treated with RLN decompression. Bilateral RLN paralyses were caused by revised thyroid surgery in 8 cases and by primary thyroid surgery in 7 cases.

RESULTSRLN injuries were found in 15 cases/22 side, including RLN-cut in 9 sides and RLN-ligated in 13 sides. RLN decompression was performed in the 10 cases/13 sides of ligated RLN. Vocal cord mobility was detected through electrolaryngoscope for evaluating the postoperative functional recovery of decompressed RLN.Of 8 patients with bilateral RLN paralyses due to the ligation of RLN after previous revised thyroid surgeries, functional adduction and abduction of the vocal cord was recovered completely in 4 patients and recovered basically with a slight weak abduction in one patient after RLN decompression, and the 5 patients were decannulated in 1-4 months postoperatively. For 7 patients with bilateral RLN paralyses resulted from previous primary surgeries, unilateral or bilateral RLN decompress was performed in 2 cases and in 3 cases respectively. The mobility of the paralyzed vocal cord restored in 1-6 months after RLN decompression, besides one case with relative deficient abduction and one case with slight limited abduction and adduction, and the 5 patients were decannulated successfully.

CONCLUSIONExploration surgery could be performed as soon as possible in patients with bilateral RLN paralyses and RLN decompress is effective for the restoration of the function of the nerve.