再手術時に反回神経再建術を行った再発進行甲状腺癌の１例

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  • RECONSTRUCTION OF THE RECURRENT LARYNGEAL NERVE IN A PATIENT WITH RECURRENT THYROID CANCER WHO HAD UNDERGONE RESECTION OF THE RECURRENT LARYNGEAL NERVE IN A PREVIOUS OPERATION

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A 72-year-old woman underwent a left hemi-thyroidectomy, modified radical neck dissection and resection of the left recurrent laryngeal nerve (T4, Ex2, N1) due to invasive papillary thyroid carcinoma. Five years later, recurrence of thyroid cancer was diagnosed. Unilateral vocal cord paralysis was observed on bronco-fiber examination. After the resection of the recurrent tumor, reconstruction of the left recurrent laryngeal nerve, which had been resected in the previous operation, was camed out. We could not utilize the left ansa cervicalis because of the previous lymph node dissection. The proximal edge of the recurrent laryngeal nerve was identified by separation of the inferior constrictor. An anastomosis of the right ansa cervicalis to left recurrent laryngeal nerve was performed in front of the trachea. After the operation, the patient's phonation gradually improved and the maximum phonation time recovered. Even in re-operation cases, reconstruction of the recurrent laryngeal nerve is possible and recovery of phonation can be expected.

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