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Benign thyroid disease and vocal cord palsy
J M Rowe-Jones1, R P Rosswick, S E Leighton
1St George's Hospital and Medical School, London.
Annals of the Royal College of Surgeons of England
|July 1, 1993
Summary
Routine preoperative laryngoscopy is recommended for thyroid surgery patients to identify vocal cord paresis. This finding in goiter cases doesn't always mean malignancy, allowing for nerve preservation and recovery.
Area of Science:
- Otolaryngology
- Endocrinology
- Surgical Oncology
Background:
- Vocal cord palsy can be a preoperative concern in patients undergoing thyroid surgery.
- Distinguishing between benign and malignant causes of vocal cord issues is crucial for surgical planning.
Purpose of the Study:
- To evaluate the incidence and significance of preoperative vocal cord palsy in thyroid surgery patients.
- To determine the association between preoperative vocal cord palsy and benign thyroid pathology.
- To assess the recovery of vocal cord function after surgery.
Main Methods:
- Retrospective analysis of 2453 thyroid surgery patient case notes.
- Inclusion of patients with successful preoperative laryngoscopy.
- Examination of preoperative vocal cord palsy and its correlation with pathology and surgical outcomes.
Main Results:
- 2321 out of 2408 patients without prior surgery had benign thyroid pathology.
- 29 patients presented with preoperative vocal cord palsy, 22 associated with benign disease.
- 89% of patients with benign goiter experienced return of vocal cord movement post-surgery.
Conclusions:
- Routine preoperative laryngoscopy is advocated to detect vocal cord paresis.
- Preoperative vocal cord palsy in goiter patients does not necessarily indicate malignancy.
- Identification and preservation of the recurrent laryngeal nerve during surgery facilitate vocal cord function recovery.