Total thyroidectomy (surgical removal of the whole thyroid gland) is standard treatment for papillary carcinoma of the thyroid.
Despite standard protection of the recurrent laryngeal nerve and conservation of the parathyroid glands, permanent post-operative malfunction occurs at around 3% and 2.6% respectively1, [full text]. However, complication rates vary with operative experience of the individual surgeon2, and can be 4 times greater for those undertaking fewer than 10 thyroidectomies per year than for those performing more than 100 annually3.
3% of British medical malpractice actions against general surgeons involve thyroidectomy4. Recurrent laryngeal nerve injury is the almost exclusive Cause of Action. Temporary injury, resolving within a year, is 6-9 times as common as permanent, and is a sensitive measure of surgical technique. Such temporary injury occurs least often after operations by surgical residents and experienced specialists2, and is most common when a typical surgeon is undertaking his/her 45-65th thyroidectomy.
The only Canadian case-law found for the plaintiff but on grounds of lack of informed consent for total thyroidectomy5
Copyright © 2009 Electronic Handbook of Legal Medicine