J Endocr Surg.  2017 Dec;17(4):139-148. 10.16956/jes.2017.17.4.139.

Bilateral Vocal Palsy After Total Thyroidectomy: Expert Opinion on Two Malpractice Claims

• Dionigi G
• Sun H
• Chai YJ
• Catalfamo
• Mangraviti A
• Rizzo GA
• Portinari
• Wu CW

• KMID: 2397990
• DOI: http://doi.org/10.16956/jes.2017.17.4.139

Abstract

Two patients complained of hoarseness, respiratory distress and swallowing disorders early after total bilateral thyroidectomy for multinodular goiter and cancer, respectively. Faulty surgical techniques had caused injury to bilateral recurrent laryngeal nerves (RLNs) during thyroidectomy and the associated central lymph node dissection. The operation notes showed no statement regarding the identification, dissection, exposure and/or functional integrity of the RLN on either side of the thyroid and no mention of the first resected lobe. This report reviews the personal experience of the authors in thyroid surgery for use in 2 medical malpractice claims and for future reference.

Keyword

Recurrent laryngeal nerve injury; Vocal cords; Tracheostomy; Nodular goiter; Intraoperative Neurophysiological monitoring; Standards

MeSH Terms

Deglutition Disorders
Expert Testimony*
Goiter
Goiter, Nodular
Hoarseness
Humans
Intraoperative Neurophysiological Monitoring
Lymph Node Excision
Malpractice*
Paralysis*
Recurrent Laryngeal Nerve
Recurrent Laryngeal Nerve Injuries
Thyroid Gland
Thyroidectomy*
Tracheostomy
Vocal Cords

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