Abstract: Objective To investigate the relationship between procedures and complications in thyroid surgery, and the implication of preserving recurrent laryngeal nerves (RLN), the external branches of superior laryngeal nerves (EBSLN), and parathyroid glands in thyroidectomy. Methods Clinical data of 152 patients with benign or malignant thyroid tumors were reviewed. All these patients underwent thyroidectomy with meticulous capsular dissection and peservation of RLN, EBSLN and parathyroid glands. Results 262 RLNs in 152 patients were identified and preserved, while 75.3% EBSLNs(174/231) were identified. In 150 patients, at least one parathyroid were identified and preserved in situ, while 2 patients underwent parathyroid autotransplantation. Transient RLN palsy occurred in 1 case and recovered within three months after the surgery. No EBSLN palsy was found. Transient hypoparathyroidism occurred in 13 cases after the surgery and recovered within one week in 9 cases, four weeks in 3 cases and 5 months in 1 case. Conclusion Identification and preservation of RLN, EBSLN and parathyroid gland in thyroidectomy is recommended in thyroid surgery to effectively avoid the complications, such as injury of RLN/EBSLN and parathyroid glands, which retains the functions of larynx and parathyroid glands and improves cure rate of thyroid tumor.

Key words: Parathyroid, Meticulous capsular dissection, Surgical complications, Thyroid, External branches of the superior laryngeal nerves, Recurrent laryngeal nerve