THYROIDECTOMY USING MICROSURGICAL NEUROLYSIS OF THE RECURRENT LARYNGEAL NERVE. CLINICAL CASE

Background. The percentage of complications after thyroid surgery remains high despite the development of surgical treatment technologies and safety, reaching 54.4% of cases. The most common complications are transient (up to 40% of cases) and permanent hypocalcemia (up to 3% of cases), damage to the recurrent laryngeal nerve with transient laryngeal paresis (up to 8% of cases) and permanent laryngeal paresis (up to 3% of cases), damage to the external branch of the superior laryngeal nerve, reaching 54.4-58% of cases. Clinical Case Description. The paper presents a clinical case of thyroidectomy using microsurgical neurolysis of the recurrent laryngeal nerve for diffuse nodular euthyroid goiter grade II according to the WHO classification. To perform bilateral neurolysis of the recurrent laryngeal nerve, its bilateral isolation along its length was performed, after which bilateral covering of the nerve was performed in the "muff" type with two patches. A 4 cm long autovein for patches was taken from the distal branch of the great saphenous vein in the lower leg using a minimally invasive approach. The early postoperative period was normal, and the patient was discharged in a satisfactory condition. In the late postoperative period, during control after 1 year and after 2 years, no complications affecting quality of life were detected. Conclusion. Microsurgical neurolysis of the recurrent laryngeal nerve using an autovein seems to be a promising method for preventing postoperative damage to the recurrent laryngeal nerve during thyroidectomy.