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[Surgical treatment of benign recurrent goiter with pre-existing unilateral recurrent laryngeal nerve paralysis--a report of experiences].

Operations for recurrent goiter are considered to range among the most difficult procedures in thyroid surgery, because the risk of a permanent recurrent nerve palsy increases to 10 or 30%. In case of pre-existing unilateral lesion of the nerve the danger of bilateral paralysis of the vocal chord will become even larger. The results from 29 patients with an intracapsular resection (nearly total removement of the thyroid tissue without the preparation of the recurrent nerve) are presented and compared with those found in 4 patients with an extracapsular approach. All four patients, where the operation was performed extracapsularly, must be tracheotomized although the palsy did recover within 21 days till 14 months. After an intracapsular resection of the recurrence at the side of an intact nerve (29 patients) a tracheotomy had not been necessary.