갑상선 수술 중 신경 손상에 대한 예방과 치료

Prevention and management of nerve injury during thyroidectomy

Since most thyroid cancers are slowly growing and are not fatal, prevention of surgical complications is as important as removing the lesion. Although permanent vocal cord paralysis, a significant complication of thyroid surgery, is reported to occur in about 1-2% of cases, the actual incidence is expected to be higher for various reasons. When nerve damage occurs despite the surgeon's utmost care, appropriate measures should be taken immediately. However, even with the most aggressive approach, nerve repair (neurorraphy) rarely restores normal vocal cord movement; it is known only to maintain tension in the vocal cords to prevent atrophy. Therefore, preventing nerve damage is considered much more important. To achieve this goal, a thorough preoperative examination and understanding of the anatomical variations of the nerves around the thyroid, as well as precise and careful capsular dissection, are necessary. In this paper, the authors discuss methods for preventing and treating nerve damage during thyroid surgery.