Distinct Disease and Functional Characteristics of Thyroid-Surgery-Related Vocal Fold Palsy.

Distinct Disease and Functional Characteristics of Thyroid-Surgery-Related Vocal Fold Palsy.

Thyroid. 2016 May 13;

Authors: Tseng WC, Pei YC, Wong AM, Li HY, Fang TJ

Abstract
BACKGROUND: Iatrogenic trauma induced by thyroid surgery is the most common etiology of unilateral vocal fold paralysis (UVFP). UVFP after thyroid surgery may lead to profound physical and psychosocial distress. In this study, we comprehensively evaluated UVFP caused by thyroid surgery, and compared the results with those caused by other surgical trauma.
STUDY DESIGN: Retrospective case series study.
METHODS: Patients with surgery-related UVFP were evaluated using quantitative laryngeal electromyography (LEMG), videolaryngostroboscopy, voice acoustic analysis, Voice Outcome Survey, and Short Form-36 quality-of-life questionnaire. Patients with thyroid surgery and other surgeries were compared.
RESULTS: A total of 105 patients were recruited, among whom 52 and 53 were assigned to the thyroid surgery and the other surgery group, respectively. Patients in the thyroid surgery group had a higher proportion of external branch of superior laryngeal nerve (eSLN) involvement, longer duration from disease onset to the first LEMG examination, lower jitter, higher harmonic-to-noise ratio, and better quality of life compared with the other surgery group. Specifically for patients in the thyroid surgery group, those with eSLN involvement tended to have more pronounced impairment in jitter and shimmer compared with patients without eSLN involvement.
CONCLUSION: UVFP caused by thyroid surgery has a distinct clinical presentation with relatively high involvement in the eSLN, better voice acoustics, longer waiting time before asking for evaluation, and less impact on quality of life. The involvement of eSLN in these patients further impaired their voice. Early referral is suggested for these patients especially with suspected eSLN injury.

PMID: 27177593 [PubMed - as supplied by publisher]

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