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Iatrogenic Vocal Fold Paralysis: A Population-Based Cohort Study in Taiwan
Ying-Ta Lai1, Pin-Zhir Chao1,2, Yu-Kang Chang3
1Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
The Annals of Otology, Rhinology, and Laryngology
|September 2, 2021
Summary
Iatrogenic vocal fold paralysis is linked to thyroid operations, older age, and longer hospital stays. Women experience higher rates of this condition, which affects the voice after surgery.
Area of Science:
- Otolaryngology
- Epidemiology
- Health Services Research
Background:
- Iatrogenic vocal fold paralysis (VFP) is a significant complication following various surgical procedures.
- Population-based epidemiological studies on VFP are scarce, limiting understanding of its incidence and risk factors.
Purpose of the Study:
- To investigate the epidemiology of iatrogenic unilateral vocal fold paralysis (UVFP) and bilateral vocal fold paralysis (BVFP) in the adult population of Taiwan.
- To identify surgical procedures, patient demographics, and clinical factors associated with iatrogenic VFP.
Main Methods:
- Analysis of a nationwide population-based claims database (Taiwan National Health Insurance Research Database) from 2007 to 2013.
- Inclusion of adult patients (20-90 years) who underwent specific surgeries (thyroid, parathyroid, thoracic, cardiac, anterior cervical spine) and were diagnosed with VFP.
- VFP diagnosis based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes.
Main Results:
- Thyroid, cervical spine, and cardiac surgeries were most frequently associated with iatrogenic VFP.
- Thoracic surgeries posed the highest risk for UVFP, while thyroid surgeries were also significant.
- The 51-60 age group and female sex were most commonly associated with both UVFP and BVFP. Increased length of hospital stay correlated with higher VFP incidence.
Conclusions:
- Thyroid operations, age 51-60, and extended hospital stays are key factors associated with iatrogenic VFP.
- Women exhibit a higher prevalence of surgically induced vocal fold paralysis compared to men.
- This study provides the first population-based epidemiological data on iatrogenic vocal fold paralysis.
