Summary

Objective: We brought elements contributing to the rationalization of a strategy of the recurrent nerve that could contribute to the reduction of postoperative complications.

Material and method: This is a descriptive and retrospective study of a series of 14 cases of giant goiter, collected in the Department of Otorhinolaryngology and Head and Neck Surgery of Gabriel Touré University Hospital. Bamako. It has been spread over a period of 3 years from June 2016 to June 2018. We included the weight of the surgical specimen was greater than or equal to 500 mg and whose mobility of the larynx is preserved preoperatively. The superior approach was the original way of dissection. The cricopharyngeal muscle was the essential marker.

Results: In 3 years, we collected 14 cases of giant goiter, during this period we performed 118 thyroidectomies, a rate of 11.86% of cases. The postoperative complications were noticed in a case of the hematoma of the lodge (7.1%), the release from the operation (7.1%), and the superinfection is 7.1%. Signs of hypothyroidism were found in 21.4% of cases. No recurrent laryngeal nerve lesion was observed.

Conclusion: Giant goiters are a surgical entity not supported by current recommendations. The surgeon is confronted with this entity must implement his anatomical and histological knowledge for a proper grip. A superior approach of the recurrent nerve and bloodless surgery is a guarantee of a good prognosis.

Keywords: Thyroidectomy; Giant goiter; Superior approach