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Thyroid Surgery 1

Thyroid surgery


Vignette: A 32-year-old woman presents to the clinic with a complaint of difficulty swallowing for the past few months. She additionally reports a recurrent cough and a sensation of food getting stuck in her throat. Physical examination reveals a mass in the anterior neck. Further evaluation with imaging and biopsy confirms the presence of a thyroid tumor. The surgeon plans to perform a thyroidectomy. Which of the following structures is most at risk of injury during this surgical procedure?


A) Facial nerve

B) Glossopharyngeal nerve

C) Hypoglossal nerve

D) Recurrent laryngeal nerve

E) Vagus nerve


D) Recurrent laryngeal nerve


The recurrent laryngeal nerves are branches of the vagus nerve (cranial nerve X) that are closely associated with the thyroid gland and are at risk of injury during thyroid surgery. They provide motor innervation to all intrinsic muscles of the larynx except the cricothyroid muscle, and sensory innervation to the larynx below the vocal folds. Injury to the recurrent laryngeal nerve can lead to vocal cord paralysis and hoarseness, and if both nerves are damaged, it can cause serious breathing difficulties. The other nerves listed in the choices are not closely associated with the thyroid gland and are therefore not typically at risk during thyroid surgery.


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