Microsurgical technique in thyroid surgery – a 10-year experience

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Abstract
Objective: To report the results of thyroid surgery in a University department of ENT – head and neck surgery, and to evaluate the benefits of the use of the surgical microscope in thyroid surgery.Design: A retrospective evaluation of the records of all patients who underwent thyroid surgery in the 10-year period 1987–1996.Methods: In addition to standard surgical principles the Zeiss multi-discipline universal surgical microscope with a 250 mm ocular lens was used in all cases. Total thyroidectomy was performed in all malignant cases, while unilateral lobectomy plus isthmus resection was the standard procedure in benign cases.Patients: There were 573 patients, aged 11–87 years, 444 females and 129 males. Four hundred and fifty-one had benign lesions, 122 malignant. Four hundred and eighty-nine had primary surgery, 84 underwent completion surgery or surgery for recurrent disease.Results: Primary thyroid gland surgery in benign/malignant disease resulted in permanent recurrent laryngeal nerve palsy in 0.6 per cent/3.5 per cent of the patients respectively, when calculated as nerves at risk (NAR). In benign recurrent or malignant completion surgery this complication rate was 4.5 per cent/2.9 per cent respectively.Conclusion: Thyroid surgery in our University ENT – Head and Neck Department with the use of the surgical microscope provides pleasing results, especially considering the diversity of surgeons, due to the departments' teaching responsibilities.