Laryngeal dysfunction after thyroid surgery: diagnosis, evaluation and treatment.

Area of Science:

• Otolaryngology
• Neurology
• Speech and Hearing Sciences

Background:

• Thyroid surgery poses risks to laryngeal nerves due to close anatomical proximity.
• Laryngeal nerve injury can lead to sensory-motor deficits, manifesting as dysphagia, aspiration, voice changes, and dyspnea.

Purpose of the Study:

• To outline the diagnostic procedures for evaluating neuro-laryngeal deficits post-thyroid surgery.
• To discuss conservative and surgical treatment options for laryngeal nerve paralysis.

Main Methods:

• Neuro-laryngeal evaluation using video-stroboscopy to assess vocal fold function.
• Laryngeal electromyography (LEMG) for objective assessment and prognosis.
• Aerodynamic and acoustic voice analysis for patient follow-up.
• Review of conservative (speech therapy) and surgical interventions.

Main Results:

• Comprehensive evaluation involves video-stroboscopy, LEMG, and voice analysis.
• Speech therapy is the primary conservative treatment.
• Early surgery is considered for severe functional impairments.
• Delayed surgical intervention (6-9 months) is indicated for persistent denervation or poor response to therapy.

Conclusions:

• Effective management of laryngeal nerve paralysis requires a multi-faceted approach combining diagnostic evaluation and tailored treatment.
• Surgical options like injection laryngoplasty, thyroplasty, and re-innervation procedures are available based on the specific deficit.