الفهرس 
IntroductionOnly 14 pages are availabe for public view
Abstract
Thyroid cancer is the most common endocrine malignancy; recent decades have witnessed a steady increase in its incidence. The optimal strategy for treatment of patients with thyroid cancer is complete surgical resection of clinically and radiologically evident disease within the neck. Cervical lymph node metastases are common in papillary thyroid cancer and are associated with a significant probability for loco-regional recurrence of the disease, even in low-risk patients.
The present study included 20 patients with thyroid cancer. All patients underwent total thyroidectomy plus neck dissection.
The aim of this study was to characterize the morbidity and complications of neck dissection in thyroid malignancy.
There were fifteen females (75 %) and five males (52%), their age ranged between 26 and 70 years with a mean of 50 years. All patients were subjected to thorough history taking, complete clinical examination and vocal cord assessment by indirect laryngoscopy. Laboratory investigations (Free T3, Free T4, TSH, serum Ca, and routine laboratory work up), followed by neck ultrasonography (US), and computed tomography (CT) were performed for all patients, as well as chest X-ray, and CT chest when needed. Biopsy from suspicious thyroid lesion and suspicious cervical lymph nodes (whether blind or ultrasound guided) was performed.
Neck mass related to the thyroid gland was the chief symptom in 13 patients (65%), neck mass related to metastasis in 5 patients (25%), dyspnea and/or dysphagia in 14 patients (70%) and voice change was present in one patient (5%). By local examination, lymph nodes were palpable in 12 patients (60%). All preoperative laboratory investigations were normal except for one patient with toxic goiter controlled by medication.
Ultrasonography showed enlarged thyroid gland with nodules and cervical lymphadenopathy in all patients under study. Indirect laryngoscope was done to all patients included in the study, 19 patients (95%) had bilateral mobile vocal cords, and one patient had left immobile vocal cord.
Recurrent laryngeal nerve were identified in all patients (100%), and one or more of parathyroid gland could be identified in all patients.
Post-operative numbness (circumoral/hands) was the most common encountered complication, as it was noted in 6 patients (30%), either alone or in combination with other complications. Recurrent laryngeal nerve injury with transient hoarseness of voice was the second common complication as noted in 3 patients (15%), chyle leak in one patient (5%). Postoperative drains collect from 50 to 100 ml with a mean 52.5± 11.8.
Postoperative Histo-pathological results showed that metastatic LNs were distributed in the levels of the neck either alone or in combination with other levels, showing that the most affected level was level VI (100%), then levels II, III and IV (80% each), then level V (15%).