Treatment of laryngeal paresis after thyroid surgery

Background. A frequent complication during operations on the thyroid gland is damage to the lower or upper laryngeal nerves, followed by the development of laryngeal paresis, with changes in breathing, phonation and impaired swallowing. In general, the incidence of postoperative complications varies considerably: different authors indicate a range from 0.2% to 15%, with an increase in persistent innervation disorders in repeated interventions (1-5%) compared with primary thyroid surgery (15-30%). If non-persistent paralyses are eliminated within 1-3 months after surgery, persistent disorders are a serious problem that requires a complex therapeutic approach and may cause disability of patients in certain professions.

Objective. The purpose of the article is to summarize and systematize the available literature data on therapeutic interventions for postoperative laryngeal paresis, to determine the most effective modern treatment methods; also consider preventive measures and ways to optimize early diagnosis of this complication of thyroid surgery.

Results. An analysis of conservative approaches to the treatment of laryngeal paresis (psychotherapy, physiotherapy, phonopedia, drug treatment) was carried out. Surgical methods for treating laryngeal paresis are considered, methods of prevention and ways to optimize early diagnosis of postoperative laryngeal paresis are presented.

Conclusion. Despite the active implementation of intraoperative monitoring and other preventive measures, complications are still possible during thyroid surgery. Comparative studies with large cohorts of patients assessing the superiority of one method over another are rare, and the results of small comparative studies are inconsistent. It is likely that a combined approach should be considered in the treatment of postoperative laryngeal paresis, taking into account possible regional health care facilities and patient preferences.

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