The anatomy and pathophysiology of the recurrent laryngeal nerve (RLN) is a research focus of the Endocrine Unit.
We have detected differential rates of RLN palsy for both hemithyroidectomy and total thyroidectomy, which may be related to differences in the RLN diameter, the tensile stress within the RLN and different rates of bifurcation of the nerve on the right and left side.
In prospective studies to understand the underlying mechanism of neurapraxia, we examined changes in electromyography (EMG) amplitude as a result of nerve stimulation following traction on the RLN at the time of thyroidectomy. A further study found a correlation between change in nerve diameter during thyroidectomy with postoperative changes in voice in the absence of RLN palsy.
A Monash University-wide Thyroid Cancer Registry has been established and we have ongoing collaborative projects with The Royal North Shore Hospital in both papillary and medullary thyroid cancer (Lee JC et al., Oncology 2014). A study with the Anaesthetic Department described airway management in patients undergoing thyroidectomy who have large retrosternal goiters.