Efficacy of intraoperative single dose methylprednisolone on recurrent laryngeal nerve function after thyroidectomy

Abstract

Recurrent laryngeal nerve (RLN) palsy is an important complication of thyroid surgery. Injuries can either be permanent or temporary. Prevention or shortening the recovery period of temporary palsies is an area of interest. Some surgeons prefer to use corticosteroids for this purpose as is used for facial nerve palsies although there are conflicting data in the literature. We aimed to investigate the efficacy of perioperative single dose methylprednisolone on recurrent laryngeal nerve function. A total of 438 nerves under risk in 237 surgeries are investigated in 2 groups. In Group 1, patients are administered a single intraoperative dose of methylprednisolone (1 mg/kg) intravenously for 220 nerves under risk. A total of 218 nerves under risk in Group 2 were operated and followed without methylprednisolone. The demographic data of the patients, operation time, the final pathology reports, incidence of recurrent laryngeal nerve palsy, and recovery time are documented and compared. No statistically significant difference was determined in terms of age, sex distribution, number of nerves under risk, and the operation time between groups. There were 3 unilateral RLNP in each group and the mean recovery time for Group 1 and 2 palsies were 20.4 and 19.8 days, respectively, without statistical significance. The presented data indicates that a single intraoperative dose of steroid does not seem to affect the rate and recovery period of RLNP in thyroid surgery.