XXXX and reoperative parathyroidectomy. A prospective study.

@entity1 @entity3746
One hundred sixty-three @entity1 undergoing reoperative parathyroidectomy were evaluated before and after operation to determine the incidence of, risk factors for, and morbidity of @entity3746 . These @entity1 were compared to 77 @entity1 undergoing initial parathyroid operation, only one of whom had @entity3746 on postoperative indirect laryngoscopy (1.3%). Preoperative examination of the reoperative @entity1 revealed @entity3746 from initial exploration in 11 @entity1 who were excluded from this study. After re-exploration, 10 @entity1 (6.6%) had @entity3746 , eight unilateral and two bilateral. Right vocal cords were paralyzed twice as often as left. In 90%, @entity3746 was associated with removal or biopsy of an ipsilateral gland. @entity3746 occurred despite intraoperative visualization of the recurrent laryngeal nerves. Preoperative localization, parathyroid gland pathology, and concomitant thyroidectomy were not associated with increased risk of @entity3746 . Hoarseness was the major symptom. Tracheostomy was required for two @entity1 , one was permanent. One @entity1 was treated for aspiration with a temporary gastrostomy. Nine of 10 @entity1 had return of normal voice quality in an average of 4 months time. On examination 4 years or more after surgery, two of five @entity1 had normal vocal cord motion. The oblique anatomic course of the right recurrent laryngeal nerve may account for the greater frequency of right @entity3746 .
