SYSTEMATIC REVIEW article
Front. Surg.
Sec. Otorhinolaryngology - Head and Neck Surgery
Risk Factors for Recurrent Laryngeal Nerve Injury Following Thyroid Surgery: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Nanchong Central Hospital, Nanchong, China
- 2Nanchong Central Hospital Affiliated to North Sichuan Medical College, Nanchong, China
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Background: Recurrent laryngeal nerve injury is one of the most common and severe complications in thyroid surgery, potentially leading to postoperative hoarseness, dysphagia, or even airway obstruction. Although numerous studies have investigated its risk factors, findings remain inconsistent. This systematic review and meta-analysis aim to synthesize existing evidence and explore risk factors for recurrent laryngeal nerve injury following thyroid surgery. Methods: A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library databases from their inception to October 1, 2025, to identify observational studies and randomized controlled trials investigating risk factors for recurrent laryngeal nerve injury following thyroid surgery. Two researchers independently performed literature screening, data extraction, and quality assessment using the Newcastle–Ottawa Scale (NOS). Stata 15 software was used to calculate pooled odds ratios (OR) and 95% confidence intervals (CI). Results: A total of 20 articles(N=108343) included, meta-analysis results suggest that older age [OR = 1.45, 95% CI (1.26, 1.66)], Female [OR = 1.15, 95% CI (1.03, 1.28)], extended thyroidectomy [OR = 1.65, 95% CI (1.20, 2.27)], node dissection [OR = 2.28, 95% CI (1.67, 3.09)],reoperation [OR = 2.16, 95% CI (1.86, 2.50)], retrosternal goitre [OR = 2.85, 95% CI (1.87, 4.35)], lack of neuromonitoring [OR = 1.64, 95% CI (1.31, 2.06)] may be associated with RLNI following thyroid surgery. Conclusion: This study indicates that older age, female gender, extended thyroidectomy, lymph node dissection, reoperation, retrosternal goiter, and absence of nerve monitoring mya be independent risk factors for recurrent laryngeal nerve injury following thyroid surgery.
Keywords: Meta-analysis, Recurrent laryngeal nerve injury, Risk factors, Systematic review, Thyroid Surgery
Received: 24 Oct 2025; Accepted: 10 Dec 2025.
Copyright: © 2025 Yang, Ouyang and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiang Yang
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