Intraoperative Identification versus non-Identification of External Branch of Superior Laryngeal Nerve on Post-Thyroidectomy Voice Changes in Qena University Hospital

Mubarak, Mohammed Mahmoud; Omar, Mohamed Ahmed; Saeed, Mohamed Mansour; Abozeid, Mahmoud A.

doi:10.21608/svuijm.2025.372562.2156

Intraoperative Identification versus non-Identification of External Branch of Superior Laryngeal Nerve on Post-Thyroidectomy Voice Changes in Qena University Hospital

Document Type : Original research articles

Authors

¹ General Surgery Department, Faculty of Medicine, South Valley University, Qena, Egypt.

² Hepato-Pancreato-Biliary Surgery and laparoendoscopy Division, General Surgery Department , Faculty of Medicine, South Valley University, Qena, Egypt.

10.21608/svuijm.2025.372562.2156

Abstract

Background: Total thyroidectomy is a common surgical procedure for thyroid disordersbut carries risks, including hypocalcemia and nerve injury, particularly to the external branch of the superior laryngeal nerve (EBSLN). While nerve identification may reduce injury, its role remains debated.
Objectives: To compare the effect of intraoperative EBSLN identification versus non-identification on postoperative voice changes in patients undergoing total thyroidectomy.
Patients and methods: This was aprospective, comparative study which included 80 patients undergoing total thyroidectomy at Qena University Hospital over an 8-month period. Patients were divided into: Group 1 (n=60): EBSLN was not identified intraoperatively, and Group 2 (n=20): EBSLN was identified intraoperatively. All patients underwent a comprehensive evaluation, including medical history, physical examination, and ENT examination with laryngoscopy.
Results: No significant differences were observed between the two groups regarding age (P=0.4011), gender distribution (P=0.3053), or operative time (P=0.7428). Postoperative voice outcomes were similar between both groups: normal voice in 90% and 88.33% (P=0.8381), dysphonia in 10% and 6.67% (P=0.624), and high-pitched voice loss in 0% and 5% in the identified versus the non-identified groups (P=0.2453). Laryngoscopic findings revealed normal vocal cord function in 90% vs 88.33% (P=0.8381), bowing in 5% vs6.67% (P=0.0711) in the identified versus the non-identified groups, and weak mobility in 5% of both groups (P=0.99). The rate of EBSLN injury was comparable between both groups (10% vs. 11.67%, P=0.838).
Conclusion: Intraoperative EBSLN identification does not significantly reduce postoperative voice changes; thus, advanced techniques are required for better nerve preservation.

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