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Vocal Fold Immobility After Radiofrequency Ablation of Thyroid Nodules: A Survey of Laryngologists and an Algorithm
Vaninder Kaur Dhillon1, Catherine Fiona Sinclair2,3
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Bethesda, Maryland, USA.
Background:
Rates of vocal fold motion impairment (VFMI) during and after thermal ablative treatments for thyroid nodules have not been well documented. This study surveys a large group of laryngologists to assess the rate of VFMI and dysphonia referral patterns after thermal ablation. A peri-procedural voice assessment algorithm for proceduralists performing thermal ablation for thyroid nodules is presented.
Methods:
Thirteen-question-survey related to VFMI postablation.
Results:
Sixty-one respondents completed the survey. One-third of total respondents affirmed a VFMI after thermal ablation, with 81% documenting evidence on laryngeal examination. Immediate dysphonia was the most common presenting symptom. Referral patterns varied, but a large portion of patients were referred more than one week postprocedure despite the proceduralist having knowledge of potential VFMI.
Conclusion:
VFMI is a risk during thermal ablation of thyroid nodules. Greater attention to voice during ablation and use of a procedural voice assessment algorithm may mitigate the risk of injury and potentially improve outcomes.
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