Introduction: Clinical and biological manifestations after total thyroidectomy constitute one of ... more Introduction: Clinical and biological manifestations after total thyroidectomy constitute one of the frequent reasons for consultation in our medical services. Several studies on thyroid pathology have been carried out in Mali, but none to our knowledge has been devoted to the postoperative clinical and biological follow-up of hyperthyroid goitres after total thyroidectomy, hence the interest of this study which aimed to evaluate the clinico-biological manifestations after total thyroidectomy of hyperthyroid goitres in the department of Endocrinology-Internal Medicine, Surgery of the Hospital of Mali. Materials and methods: This was a descriptive, retrospective study from January 2010 to December 2014. All patients who had undergone total thyroidectomy for hyperthyroid goiter, who were treated before discharge with levothyrox (50 to 150 µg/day) to prevent hypothyroidism, who had a complete file and who were followed up in the Endocrinology-Internal Medicine and Thoracic Surgery Depa...
Objectives: We report two cases of nasopalatine cyst by discussing the diagnostic and therapeutic... more Objectives: We report two cases of nasopalatine cyst by discussing the diagnostic and therapeutic aspect and review the literature. Case report: There were two cases of nasopalatin cyst aged 20 years and 19 years respectively. We noted a mass filling the upper vestibular in our two patients. Computed tomography showed a fluid cyst located in the nasopalatin duct. Surgery was performed under general anesthesia in the first patient and local anesthesia in the second patient. Anatomopathological examination of the room highlighted a cyst. No operative incident was noted. Conclusion: The nasopalatin cyst is an epithelial, embryonic non-odontogenic tumor of the maxillae. His diagnosis is radiological and histological. The vestibular surgical approach may allow complete excision of the cyst without dental, neurovascular and bucco-nasal fistula lesions.
International Journal of Otorhinolaryngology, 2020
Introduction: acute pharyngitis is found in children as well as in adults. The peak incidence is ... more Introduction: acute pharyngitis is found in children as well as in adults. The peak incidence is between 5 and 15 years. The responsible germs are of viral or bacterial origin; the group A hemolytic beta streptococcus haunts this condition. Objective: Study the factors associated with acute pharyngitis in the ENT department of the CHU Gabriel TOURE in Bamako. Methods: A descriptive and analytical prospective study was conducted from August 30, 2015 to August 30, 2016. The study population consisted of patients admitted to the ENT department of the CHU Gabriel Touré in Bamako for acute pharyngitis. Data was collected using a questionnaire during the interview and physical examination. They were entered using Epi Data software version 3.01 and analyzed using R 3.1.2 software. Results: We collected 234 cases of pharyngitis between August 30, 2015 and August 30, 2016. The sex ratio (F / M) was 1.32. The mean age was 28.21 ± 14.20 years. The majority of patients presented with erythematous angina (81%). The group A hemolytic beta streptococcus was the predominant germ (58%). The active antibiotics on the germ were penicillin, amoxicillin, and cephalosporin. This germ was associated with erythematous angina and the risk was 3.99, CI (1.88-8.45). Complications were noted in 7 patients (3%) upon admission, including 1 case of cervical cellulitis and 6 cases of palatine tonsil phlegmon. No deaths have been recorded. Conclusion: The aspect of the palatine tonsil does not allow to evoke a viral or bacterial etiology from where the interest to carry out a bacteriological examination in particular the culture which could orient a bacterial etiology and help the practitioner to rationalize the indication of antibiotic therapy.
Objectives: We wanted to discuss the aetiopathogenic, diagnostic and therapeutic of nasal tubercu... more Objectives: We wanted to discuss the aetiopathogenic, diagnostic and therapeutic of nasal tuberculosis aspect. Clinical case: This is a 10-year-old patient admitted for nasal blistering ulceration. The diagnosis of nasal tuberculosis was retained after histopathological examination. After the clinical and paraclinical investigations, we retained multifocal tuberculosis in front of tuberculosis of the ear, pulmonary and a pain of pott. The therapeutic antituberculous inclusion to the two-month regimen of rifampicin + isoniazid + pyrazinamide + ethambutol and 4-month rifampicin + isoniazid. We noted a clear improvement at four months of treatment, nasal, pulmonary, otological lesions but with sequelae at the dorsal level. Any recurrence after one-year decline. Nasal tuberculosis, although rare, remains a reality in our country. In front of a nasal ulceration and a nasal obstruction must make search for nasal tuberculosis. Careful clinical examination can detect more complications.
This work on otospongios is to evaluate our experience in management. It is a rare pathology in o... more This work on otospongios is to evaluate our experience in management. It is a rare pathology in our context more precisely in the black race. The studies on this pathology concerned the study on whites. The prevalence of this pathology remains obscure in our context. In our structure we have tried to highlight the diagnostic and therapeutic aspects. We collected fourteen cases of otosclerosis. The clinical examination and the computed tomography allowed us to choose the operable cases in 85.8% with favorable consequences. Our study highlights the lack of management familiarity of these cases especially in the black race.
Infratentorial subdural empyemas are rare. It is an important neurological infection requiring im... more Infratentorial subdural empyemas are rare. It is an important neurological infection requiring immediate neurosurgical treatment. The nonsurgical treatment of subdural empyema has been reported sporadically. In this paper the authors report the nonsurgical treatment of a case of infratentorial subdural empyema. The patient with left recurrent otitis was hospitalized with symptoms of headache and fever of 3 weeks duration. Examination revealed that the patient had Glasgow Coma Scale score of 15, fever, mild cerebellar signs, no focal deficit, and abundant suppuration from the left ear. A contrast-enhanced CT scan showed an infratentorial supracerebellar hypodense fluid collection with the peripheral rim enhancement to the left of the midline that mimicked a subdural empyema. Routine hematological investigation revealed polymorphic leukocytosis and elevated erythrocyte sedimentation rate. After the left mastoidectomy and antibiotic treatment, the patient recovered with complete resolution of the subdural empyema on CT scan.
International Journal of Otolaryngology and Head & Neck Surgery
Objectives: To study the clinical and therapeutic profiles of voluminous goiter. Patients and Met... more Objectives: To study the clinical and therapeutic profiles of voluminous goiter. Patients and Methods: We carried out a descriptive and prospective study, relating to a series of 30 cases of voluminous goitre, collected in the Department of Otorhinolaryngology and cervicofacial surgery (ENT and CCF) of the CHU Luxembourg Mother Child of Bamako. It has been spread over a period of 4 years from January 2015 to December 2018. Patients of all ages operated for large goitre at the ENT Department of CHU Luxembourg Mother Enfant were included. Results: In 4 years we collected 30 cases of voluminous goitre; during this period we realized 180 thyroidectomies, i.e. frequency of 16.67%. The average age was 51.37 years with an extreme ranging from 38 to 65 years. Females were common in 66.7% with a sex ratio of 0.50. The long duration of evolution has been 40 years. The sign of compression was found in 85.7%. The physical examination found a mobile swelling, hard and painless in all patients with normal endolaryngeal examination; there was no cervical lymphadenopathy. The lower dipping pole was found in 5 cases on CT. All our patients were euthyroid. The classification of TIRADS 2 was found in 80.0% of cases. Total thyroidectomy was frequent with 50.0% of cases. The average weight of the operative specimen was 586.67 g with extremes ranging from 500 g to 800 g. The size of the operative piece of 14 cm was the longest. Injury of internal jugular vein was found in 26.7% of cases. Colloid adenoma of the thyroid was found in 100% of cases, postoperative How to cite this paper: Sidibé, Y., Haidara, A.complications of the type of hematoma of the lodge in 3.3% of cases, the release of the operative wound in 10% of cases local superinfection in 7.1%. Signs of hypothyroidism were common with 50.0%. Postoperative nasofibroscopy found good vocal fold mobility in all patients. Conclusion: The large goiters have become rare because of the early management of thyroid nodule. Its management must allow the prevention of recurrent and parathyroid morbidity.
International Journal of Otolaryngology and Head & Neck Surgery
Tonsillitis or angina, is considered as an inflammation of the palatine tonsils most often of inf... more Tonsillitis or angina, is considered as an inflammation of the palatine tonsils most often of infectious origin. It can be acute or chronic. The germs in question are mostly viruses and bacteria. Objectives: The objective of this work was to study the epidemiological and therapeutic profile of tonsillitis and their complications in the ENT Department and Head and Neck Surgery of the Mother-Child University Hospital in Luxembourg. Patients and Methods: This is a prospective study over a 12-month period from January 2018 to December 2018, including all patients who presented with tonsillitis and/or their complications. Results: Three hundred and fifteen (315) patients were collected during this period. The average age in our study was 14.25 years with extremes ranging from 2 years to 61 years. The sex ratio was 0.65 in favor of the female sex. During this period we recorded 80.95% of cases of uncomplicated tonsillitis including 60.50% for acute tonsillitis, 24.5% for chronic tonsillitis 5% for adenoid tonsillitis and 19.05% for complications. Complications included peritonsillar phlegmon 42.22%, heart disease 33.33%, cervical cellulitis 8.89%, adeno-phlegmon 6.67%, para-pharyngeal abscess 4.44%, and sepsis 4.44%. The exclusive medical treatment was performed in 44.31%. Surgical treatment (drainage incision and tonsillectomy) was performed in 55.69%. Conclusion: Tonsillitis and its complications represent an important pathology in ENT. Feynophagy febrile is the pair-origin symptom that can lead to the diagnosis. The prevention of complications is the guarantor of the How to cite this paper: Haidara, A.
International Journal of Otolaryngology and Head & Neck Surgery
Objective: Provide the place of ENT diseases at the Reference Health Center of the Commune V of B... more Objective: Provide the place of ENT diseases at the Reference Health Center of the Commune V of Bamako. Materials and Method: A cross-sectional study using ENT medical assessment was carried out from January 2017 to December 2017 at the Reference Health Center of Commune V of Bamako's District. Results: 1911 patients were included and that number represented 15.46% of all non-obstetrics medical consultations in the health center. The sex ratio was 0.83 for women (54.7%). The average age was 22 years old. Otologic diseases were 66.4% of the cases followed by nasal sinus cases (16.6%). Infectious and inflammatory diseases were 74.1% and were the main diagnosed diseases. The difficulties were mainly from technical platform. Conclusion: The diversity of these pathologies required a strong development or reinforcement of human and material resources capacities in of these structures for proximity care management.
International Journal of Otolaryngology and Head & Neck Surgery
Background: Tonsillectomy is one of the most commonly performed surgical operations in the recent... more Background: Tonsillectomy is one of the most commonly performed surgical operations in the recent years. It is mainly done for chronic tonsillitis and obstructive symptoms. Aims & Objectives: To compare the operating time, intraoperative blood loss, postoperative pain, time needed to return to normal diet and activity in coblation and dissection tonsillectomy. Methods: This is a prospective study done at Pushpagiri Medical College for a period of one and a half years from March 2015 to September 2016. Out of the 50 patients, 25 underwent coblation tonsillectomy and 25 underwent conventional dissection tonsillectomy. Method of surgery depended on patients' or parents' choice. Intra operative measures like operating time, blood loss and post-operative morbidity were measured and compared. Results: In this study, there was significant difference in intraoperative time in coblation tonsillectomy compared to cold dissection tonsillectomy (mean operative time-13.4 minutes for coblation and 20.4 minutes for cold dissection with p value less than 0.05). Intraoperative blood loss was significantly less for coblation (18.9 ml) compared to traditional (43.0 ml) with p value 0.002. Average postoperative pain score 6 hours after operation was 7.6 for coblation and 8.5 for cold dissection with a significant p value of 0.002. Average time taken to return to normal diet among coblation was 6.4 days and dissection was 7.0 days with p value of 0.078 which is not statistically significant. However, average time taken to return to normal activity among coblation was 6.3 days and dissection was 7.1 days with a significant p value of 0.024. Conclusion: Coblation tonsillectomy significantly reduces the operation time, intraoperative blood loss, immediate postoperative pain, and patient returns early to regular routine, but with a higher cost.
Objectives: We report two types of anatomical variations of the recurrent laryngeal nerve in two ... more Objectives: We report two types of anatomical variations of the recurrent laryngeal nerve in two patients. Through these two patients we wanted to highlight our surgical approach of the recurrent nerve in an unusual position and to describe the surgical implication of these almost rare variations. Case report: patient aged 28 and 58 admitted for goiter. They underwent a right lobisthmectomy. Both recurrences were approached retrograde. The anatomical variations of the nerve concerned the non-recurrent laryngeal nerve in the first patient. In the second patient there were three anatomical variations, namely an extra laryngeal bifurcation of the nerve, a pre-vascular position of the nerve and a branch connecting the vagus nerve and the recurrent nerve. No recurrence nerve injury was noted. Conclusion: The anatomical variations of the nerve are numerous. A careful dissection is a guarantee of a good prognosis.
Introduction: Clinical and biological manifestations after total thyroidectomy constitute one of ... more Introduction: Clinical and biological manifestations after total thyroidectomy constitute one of the frequent reasons for consultation in our medical services. Several studies on thyroid pathology have been carried out in Mali, but none to our knowledge has been devoted to the postoperative clinical and biological follow-up of hyperthyroid goitres after total thyroidectomy, hence the interest of this study which aimed to evaluate the clinico-biological manifestations after total thyroidectomy of hyperthyroid goitres in the department of Endocrinology-Internal Medicine, Surgery of the Hospital of Mali. Materials and methods: This was a descriptive, retrospective study from January 2010 to December 2014. All patients who had undergone total thyroidectomy for hyperthyroid goiter, who were treated before discharge with levothyrox (50 to 150 µg/day) to prevent hypothyroidism, who had a complete file and who were followed up in the Endocrinology-Internal Medicine and Thoracic Surgery Depa...
Objectives: We report two cases of nasopalatine cyst by discussing the diagnostic and therapeutic... more Objectives: We report two cases of nasopalatine cyst by discussing the diagnostic and therapeutic aspect and review the literature. Case report: There were two cases of nasopalatin cyst aged 20 years and 19 years respectively. We noted a mass filling the upper vestibular in our two patients. Computed tomography showed a fluid cyst located in the nasopalatin duct. Surgery was performed under general anesthesia in the first patient and local anesthesia in the second patient. Anatomopathological examination of the room highlighted a cyst. No operative incident was noted. Conclusion: The nasopalatin cyst is an epithelial, embryonic non-odontogenic tumor of the maxillae. His diagnosis is radiological and histological. The vestibular surgical approach may allow complete excision of the cyst without dental, neurovascular and bucco-nasal fistula lesions.
International Journal of Otorhinolaryngology, 2020
Introduction: acute pharyngitis is found in children as well as in adults. The peak incidence is ... more Introduction: acute pharyngitis is found in children as well as in adults. The peak incidence is between 5 and 15 years. The responsible germs are of viral or bacterial origin; the group A hemolytic beta streptococcus haunts this condition. Objective: Study the factors associated with acute pharyngitis in the ENT department of the CHU Gabriel TOURE in Bamako. Methods: A descriptive and analytical prospective study was conducted from August 30, 2015 to August 30, 2016. The study population consisted of patients admitted to the ENT department of the CHU Gabriel Touré in Bamako for acute pharyngitis. Data was collected using a questionnaire during the interview and physical examination. They were entered using Epi Data software version 3.01 and analyzed using R 3.1.2 software. Results: We collected 234 cases of pharyngitis between August 30, 2015 and August 30, 2016. The sex ratio (F / M) was 1.32. The mean age was 28.21 ± 14.20 years. The majority of patients presented with erythematous angina (81%). The group A hemolytic beta streptococcus was the predominant germ (58%). The active antibiotics on the germ were penicillin, amoxicillin, and cephalosporin. This germ was associated with erythematous angina and the risk was 3.99, CI (1.88-8.45). Complications were noted in 7 patients (3%) upon admission, including 1 case of cervical cellulitis and 6 cases of palatine tonsil phlegmon. No deaths have been recorded. Conclusion: The aspect of the palatine tonsil does not allow to evoke a viral or bacterial etiology from where the interest to carry out a bacteriological examination in particular the culture which could orient a bacterial etiology and help the practitioner to rationalize the indication of antibiotic therapy.
Objectives: We wanted to discuss the aetiopathogenic, diagnostic and therapeutic of nasal tubercu... more Objectives: We wanted to discuss the aetiopathogenic, diagnostic and therapeutic of nasal tuberculosis aspect. Clinical case: This is a 10-year-old patient admitted for nasal blistering ulceration. The diagnosis of nasal tuberculosis was retained after histopathological examination. After the clinical and paraclinical investigations, we retained multifocal tuberculosis in front of tuberculosis of the ear, pulmonary and a pain of pott. The therapeutic antituberculous inclusion to the two-month regimen of rifampicin + isoniazid + pyrazinamide + ethambutol and 4-month rifampicin + isoniazid. We noted a clear improvement at four months of treatment, nasal, pulmonary, otological lesions but with sequelae at the dorsal level. Any recurrence after one-year decline. Nasal tuberculosis, although rare, remains a reality in our country. In front of a nasal ulceration and a nasal obstruction must make search for nasal tuberculosis. Careful clinical examination can detect more complications.
This work on otospongios is to evaluate our experience in management. It is a rare pathology in o... more This work on otospongios is to evaluate our experience in management. It is a rare pathology in our context more precisely in the black race. The studies on this pathology concerned the study on whites. The prevalence of this pathology remains obscure in our context. In our structure we have tried to highlight the diagnostic and therapeutic aspects. We collected fourteen cases of otosclerosis. The clinical examination and the computed tomography allowed us to choose the operable cases in 85.8% with favorable consequences. Our study highlights the lack of management familiarity of these cases especially in the black race.
Infratentorial subdural empyemas are rare. It is an important neurological infection requiring im... more Infratentorial subdural empyemas are rare. It is an important neurological infection requiring immediate neurosurgical treatment. The nonsurgical treatment of subdural empyema has been reported sporadically. In this paper the authors report the nonsurgical treatment of a case of infratentorial subdural empyema. The patient with left recurrent otitis was hospitalized with symptoms of headache and fever of 3 weeks duration. Examination revealed that the patient had Glasgow Coma Scale score of 15, fever, mild cerebellar signs, no focal deficit, and abundant suppuration from the left ear. A contrast-enhanced CT scan showed an infratentorial supracerebellar hypodense fluid collection with the peripheral rim enhancement to the left of the midline that mimicked a subdural empyema. Routine hematological investigation revealed polymorphic leukocytosis and elevated erythrocyte sedimentation rate. After the left mastoidectomy and antibiotic treatment, the patient recovered with complete resolution of the subdural empyema on CT scan.
International Journal of Otolaryngology and Head & Neck Surgery
Objectives: To study the clinical and therapeutic profiles of voluminous goiter. Patients and Met... more Objectives: To study the clinical and therapeutic profiles of voluminous goiter. Patients and Methods: We carried out a descriptive and prospective study, relating to a series of 30 cases of voluminous goitre, collected in the Department of Otorhinolaryngology and cervicofacial surgery (ENT and CCF) of the CHU Luxembourg Mother Child of Bamako. It has been spread over a period of 4 years from January 2015 to December 2018. Patients of all ages operated for large goitre at the ENT Department of CHU Luxembourg Mother Enfant were included. Results: In 4 years we collected 30 cases of voluminous goitre; during this period we realized 180 thyroidectomies, i.e. frequency of 16.67%. The average age was 51.37 years with an extreme ranging from 38 to 65 years. Females were common in 66.7% with a sex ratio of 0.50. The long duration of evolution has been 40 years. The sign of compression was found in 85.7%. The physical examination found a mobile swelling, hard and painless in all patients with normal endolaryngeal examination; there was no cervical lymphadenopathy. The lower dipping pole was found in 5 cases on CT. All our patients were euthyroid. The classification of TIRADS 2 was found in 80.0% of cases. Total thyroidectomy was frequent with 50.0% of cases. The average weight of the operative specimen was 586.67 g with extremes ranging from 500 g to 800 g. The size of the operative piece of 14 cm was the longest. Injury of internal jugular vein was found in 26.7% of cases. Colloid adenoma of the thyroid was found in 100% of cases, postoperative How to cite this paper: Sidibé, Y., Haidara, A.complications of the type of hematoma of the lodge in 3.3% of cases, the release of the operative wound in 10% of cases local superinfection in 7.1%. Signs of hypothyroidism were common with 50.0%. Postoperative nasofibroscopy found good vocal fold mobility in all patients. Conclusion: The large goiters have become rare because of the early management of thyroid nodule. Its management must allow the prevention of recurrent and parathyroid morbidity.
International Journal of Otolaryngology and Head & Neck Surgery
Tonsillitis or angina, is considered as an inflammation of the palatine tonsils most often of inf... more Tonsillitis or angina, is considered as an inflammation of the palatine tonsils most often of infectious origin. It can be acute or chronic. The germs in question are mostly viruses and bacteria. Objectives: The objective of this work was to study the epidemiological and therapeutic profile of tonsillitis and their complications in the ENT Department and Head and Neck Surgery of the Mother-Child University Hospital in Luxembourg. Patients and Methods: This is a prospective study over a 12-month period from January 2018 to December 2018, including all patients who presented with tonsillitis and/or their complications. Results: Three hundred and fifteen (315) patients were collected during this period. The average age in our study was 14.25 years with extremes ranging from 2 years to 61 years. The sex ratio was 0.65 in favor of the female sex. During this period we recorded 80.95% of cases of uncomplicated tonsillitis including 60.50% for acute tonsillitis, 24.5% for chronic tonsillitis 5% for adenoid tonsillitis and 19.05% for complications. Complications included peritonsillar phlegmon 42.22%, heart disease 33.33%, cervical cellulitis 8.89%, adeno-phlegmon 6.67%, para-pharyngeal abscess 4.44%, and sepsis 4.44%. The exclusive medical treatment was performed in 44.31%. Surgical treatment (drainage incision and tonsillectomy) was performed in 55.69%. Conclusion: Tonsillitis and its complications represent an important pathology in ENT. Feynophagy febrile is the pair-origin symptom that can lead to the diagnosis. The prevention of complications is the guarantor of the How to cite this paper: Haidara, A.
International Journal of Otolaryngology and Head & Neck Surgery
Objective: Provide the place of ENT diseases at the Reference Health Center of the Commune V of B... more Objective: Provide the place of ENT diseases at the Reference Health Center of the Commune V of Bamako. Materials and Method: A cross-sectional study using ENT medical assessment was carried out from January 2017 to December 2017 at the Reference Health Center of Commune V of Bamako's District. Results: 1911 patients were included and that number represented 15.46% of all non-obstetrics medical consultations in the health center. The sex ratio was 0.83 for women (54.7%). The average age was 22 years old. Otologic diseases were 66.4% of the cases followed by nasal sinus cases (16.6%). Infectious and inflammatory diseases were 74.1% and were the main diagnosed diseases. The difficulties were mainly from technical platform. Conclusion: The diversity of these pathologies required a strong development or reinforcement of human and material resources capacities in of these structures for proximity care management.
International Journal of Otolaryngology and Head & Neck Surgery
Background: Tonsillectomy is one of the most commonly performed surgical operations in the recent... more Background: Tonsillectomy is one of the most commonly performed surgical operations in the recent years. It is mainly done for chronic tonsillitis and obstructive symptoms. Aims & Objectives: To compare the operating time, intraoperative blood loss, postoperative pain, time needed to return to normal diet and activity in coblation and dissection tonsillectomy. Methods: This is a prospective study done at Pushpagiri Medical College for a period of one and a half years from March 2015 to September 2016. Out of the 50 patients, 25 underwent coblation tonsillectomy and 25 underwent conventional dissection tonsillectomy. Method of surgery depended on patients' or parents' choice. Intra operative measures like operating time, blood loss and post-operative morbidity were measured and compared. Results: In this study, there was significant difference in intraoperative time in coblation tonsillectomy compared to cold dissection tonsillectomy (mean operative time-13.4 minutes for coblation and 20.4 minutes for cold dissection with p value less than 0.05). Intraoperative blood loss was significantly less for coblation (18.9 ml) compared to traditional (43.0 ml) with p value 0.002. Average postoperative pain score 6 hours after operation was 7.6 for coblation and 8.5 for cold dissection with a significant p value of 0.002. Average time taken to return to normal diet among coblation was 6.4 days and dissection was 7.0 days with p value of 0.078 which is not statistically significant. However, average time taken to return to normal activity among coblation was 6.3 days and dissection was 7.1 days with a significant p value of 0.024. Conclusion: Coblation tonsillectomy significantly reduces the operation time, intraoperative blood loss, immediate postoperative pain, and patient returns early to regular routine, but with a higher cost.
Objectives: We report two types of anatomical variations of the recurrent laryngeal nerve in two ... more Objectives: We report two types of anatomical variations of the recurrent laryngeal nerve in two patients. Through these two patients we wanted to highlight our surgical approach of the recurrent nerve in an unusual position and to describe the surgical implication of these almost rare variations. Case report: patient aged 28 and 58 admitted for goiter. They underwent a right lobisthmectomy. Both recurrences were approached retrograde. The anatomical variations of the nerve concerned the non-recurrent laryngeal nerve in the first patient. In the second patient there were three anatomical variations, namely an extra laryngeal bifurcation of the nerve, a pre-vascular position of the nerve and a branch connecting the vagus nerve and the recurrent nerve. No recurrence nerve injury was noted. Conclusion: The anatomical variations of the nerve are numerous. A careful dissection is a guarantee of a good prognosis.
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