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The importance of larynx videoendoscopy in diagnosis of recurrent laryngeal nerve injury after anterior approach

INTRODUCTION: the recognition of recurrent laryngeal nerve injury (RLN) after anterior approach for treatment of disc herniation is important in the clinical evolution of patients, especially in reoperation cases. The importance of larynx videoendoscopy (VEL) has not been completely studied. OBJECTIVE: to identify the prevalence of RLN injury in symptomatic or asymptomatic patients with anterior cervical spine surgery, using VEL. METHODS: from June 2009 to July 2010 we selected 30 patients who underwent anterior approach for treatment of disc herniation in Hospital São Lucas, from PUC-RS. VEL was made in the preoperatory and in the first ten days after surgery. Patients who had an abnormal VEL were classified with RLN injury and were accompanied monthly for a period of six months, until reaching spontaneous recovery. RESULTS: we found evidende of lesion in 3/30 cases (10%), and all of them presented asymptomatic at the time of the test. In the approach from the left, we had one (33.3%) case of injury, and two (66.6%) in the approach through the right side. All injuries recovered in 120 days. We didn't found any definite injury. CONCLUSION: VEL in the preoperatory can be useful for RLN diagnosis of injuries, especially in asymptomatic patients. The lack of clinical suspicion does not exclude the possibility of LNT lesion.

Laryngoscopy; Recurrent laryngeal nerve; Intervertebral disk displacement; postoperative complications


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