Late voice function after surgical injury to the recurrent nerve

In the period 1960 to 1970, a total of 213 patients underwent subtotal thyroidectomy for benign cervical toxic goitre. Postoperatively, immobile vocal cord indicating paralysis of the recurrent nerve was found in 17 patients. In 8 patients, immobility of the vocal cord was permanent. Seven of the 17 patients received voice training which was initiated within 3 weeks after operation. After a period of 5-10 years, on an average 8 years, the 17 patients had a clinical and a comprehensive objective examination of the voice function comprising stroboscopy, electroglottography, phono-oscillometry, voice range, phonation time, peak-flow and pitch. Only a few complaints were ciliated whereas the objective examination of the voice function revealed abnormal findings in all but one patient. The findings were less abnormal in patients who had received early voice training. It is concluded that despite abnormal objective findings, all 17 patients found their voice function satisfactory. Moreover, early voice training seemed to offer a fair chance of minimizing late voice problems, whether the paralysis was permanent or transitory.