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Left recurrent laryngeal nerve paralysis (75%) occurred more frequently than right on (25%), similar to Stell and Maran series.
Two published case reports described improvement in symptoms and palliation of disease after Seihai-to therapy for refractory aspiration pneumonia caused by recurrent laryngeal nerve paralysis (Mantani et al, 1999) and by cerebrovascular disease (Mantani et al, 2000).
Some reported complications include injury to the spleen, azygos vein laceration, chylothorax, recurrent laryngeal nerve paralysis, anastomotic leaks, cardiac abnormalities, pleural injury, and tears to the posterior tracheal wall.
The two most likely reasons for a sudden onset of hoarseness following orotracheal intubation are recurrent laryngeal nerve paralysis and cricoarytenoid dislocation.
Experienced surgeons whose rates of hypocalcemia and recurrent laryngeal nerve paralysis following total thyroidectomy are low offer their patients the unambiguous advantage of superior follow-up with thyroglobulin and radioactive iodine.

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