A laryngoscopy-based classification system for perioperative abnormal vocal cord movement in thyroid surgery

Area of Science:

• Otolaryngology
• Endocrinology
• Neurosurgery

Background:

• Thyroid surgery, including partial or total thyroidectomy, can lead to abnormal vocal cord movement (AVCM).
• Accurate assessment of AVCM is crucial for managing recurrent laryngeal nerve injury.
• Existing classification schemes may not fully capture the nuances of AVCM pre- and post-thyroidectomy.

Purpose of the Study:

• To develop and validate a classification scheme for abnormal vocal cord movement (AVCM) in patients undergoing thyroid surgery.
• To correlate AVCM severity with patient outcomes and recovery rates.
• To establish the utility of pre- and postoperative laryngoscopy in identifying and evaluating AVCM.

Main Methods:

• Retrospective cohort study analyzing clinical and laryngoscopic data from 1619 patients.
• Classification of AVCM into mild (type I), moderate (type II), and severe (type III) based on laryngoscopic findings.
• Comparison of recovery rates across different AVCM types and between symptomatic and asymptomatic patients.

Main Results:

• 39 patients had preoperative AVCM and 65 had postoperative AVCM.
• Higher recovery rates were observed for type I AVCM compared to type III AVCM.
• Type II AVCM showed better recovery than type III AVCM at 1, 3, and 6 months postoperatively; asymptomatic patients had better recovery.

Conclusions:

• A practical classification system for AVCM following thyroidectomy has been established.
• Pre- and postoperative laryngoscopy are essential for identifying asymptomatic AVCM and assessing recurrent laryngeal nerve injury.
• The classification system provides a valuable tool for predicting recovery and guiding patient management.