Shaving Versus Resection on Recurrent Laryngeal Nerve in Thyroid Cancer Surgeries: A Systematic Review and Meta-Analysis
In brief
Nerve shaving links to better voice function and fewer recurrences in thyroid cancer
In 13 retrospective studies involving 532 patients, shaving tumor from the recurrent laryngeal nerve was associated with better vocal fold movement, longer speaking time, and fewer recurrences than removing the nerve; overall survival and tracheotomy rates were similar. Shaved patients had less advanced disease, so selection bias may explain the differences, and prospective comparisons are needed.
- Journal
- Head & neck (Q1)
- Published
- 8 October 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Eric Tran, Jordan Kankam, Liana Salehian, Harry May, Daniel Stuart, Yusuf Dundar
- PMID
- 42845094
- DOI
- 10.1002/hed.70509
Why clinicians should know about it
- Picked for Otorhinolaryngology (paper of the day, 11 October 2026): Shaving vs resection of RLN in thyroid cancer surgery
Abstract
BACKGROUND: Management of recurrent laryngeal nerve (RLN) invasion by thyroid cancer remains controversial between shaving the tumor and resecting it. We compared oncological and functional outcomes of the two techniques. METHODS: Following PRISMA guidelines, three reviewers searched seven databases for studies from 1995 to 2024 comparing shaving and resection of the RLN. Outcomes explored were overall survival, recurrence, preservation of vocal cord function, maximum phonation time, and other treatment-related morbidities if provided. RESULTS: A total of 13 retrospective cohorts (532 patients) met inclusion criteria. Overall survival and tracheotomy requirements did not differ between groups. Shaving was associated with lower recurrence (p = 0.007), better vocal fold mobility (p < 0.0001), and longer maximum phonation time (p = 0.04). CONCLUSION: This analysis showed that shaving was associated with better functional outcomes and lower recurrence than resection, without a survival difference. Because shaved patients had less advanced disease, these associations may reflect selection bias; prospective studies are needed.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.