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Are pre-operative vocal fold checks necessary?
1Department of Otolaryngology, Manchester Royal Infirmary, UK.
The Journal of Laryngology and Otology
|December 22, 1999
Summary
Routine pre-operative vocal fold checks are unnecessary for patients without current or historical symptoms. A retrospective analysis of 2250 checks over 26 years found only 17 cases of vocal fold palsy, all with suggestive histories.
Area of Science:
- Otolaryngology
- Surgical Outcomes
- Laryngeal Function
Background:
- Pre-operative vocal fold assessment is a common practice in ENT and cardiothoracic surgery.
- The necessity of routine pre-operative vocal fold checks in asymptomatic patients remains debated.
Purpose of the Study:
- To evaluate the utility of routine pre-operative vocal fold checks.
- To determine the incidence of vocal fold palsy in patients undergoing specific surgeries without pre-existing symptoms.
Main Methods:
- Retrospective analysis of a 26-year register (1970-1995) of pre-operative vocal fold checks.
- Inclusion of patients undergoing thyroid, parathyroid, and cardiothoracic surgery.
- Documentation and review of identified vocal fold palsies.
Main Results:
- 2250 pre-operative vocal fold checks were analyzed.
- 23 cases of vocal fold palsy were documented.
- 17 patients with documented palsy had a history suggestive of the condition; 6 had incomplete records.
Conclusions:
- Routine pre-operative vocal fold checks may not be necessary for asymptomatic patients.
- The absence of current or historical symptoms suggests a low yield for routine pre-operative vocal fold screening.
- Further investigation into cost-effectiveness and clinical guidelines is warranted.