Jong-Lyel Roh1, Yeo-Hoon Yoon, Chan Il Park. 1. Department of Otolaryngology, Asan Medical Centre, University of Ulsan, College of Medicine, Songpa-Gu, Seoul, Republic of Korea. rohjl@amc.ac.kr
Abstract
BACKGROUND: Recurrent laryngeal nerve paralysis (RLNP) occurs in patients with thyroid malignancy. This study prospectively evaluated vocal function and management outcomes of patients with papillary thyroid carcinomas (PTCs) and RLNP. METHODS: Of 319 PTC patients, 256 underwent total thyroidectomy with or without neck dissection, 42 underwent lobectomy, and 21 underwent reoperation for recurrent cancers. All patients underwent laryngoscopy and vocal function measurements before and after surgery. Patients with RLNP and poor vocal function underwent voice surgery. RESULTS: Temporary and permanent RLNP rates were 2.8% and .9% at nerve-at-risk-based analysis, respectively. Of 28 patients with tumor invasion of RLN, 14 had preoperative RLNP, with 9 of 14 showing voice changes. RLNP was detected in 9 of 291 (3.1%) patients without documented nerve injury; 8 recovered. Nine of 15 patients with RLN section had poor vocal function, which improved in 8 patients after medialization of the unilateral vocal fold. CONCLUSIONS: Patients with PTC may have vocal dysfunction from cancer or surgery-related RLNP. Vocal evaluation and management may help improve their vocal function, thus enhancing their quality of life.
BACKGROUND: Recurrent laryngeal nerve paralysis (RLNP) occurs in patients with thyroid malignancy. This study prospectively evaluated vocal function and management outcomes of patients with papillary thyroid carcinomas (PTCs) and RLNP. METHODS: Of 319 PTC patients, 256 underwent total thyroidectomy with or without neck dissection, 42 underwent lobectomy, and 21 underwent reoperation for recurrent cancers. All patients underwent laryngoscopy and vocal function measurements before and after surgery. Patients with RLNP and poor vocal function underwent voice surgery. RESULTS: Temporary and permanent RLNP rates were 2.8% and .9% at nerve-at-risk-based analysis, respectively. Of 28 patients with tumor invasion of RLN, 14 had preoperative RLNP, with 9 of 14 showing voice changes. RLNP was detected in 9 of 291 (3.1%) patients without documented nerve injury; 8 recovered. Nine of 15 patients with RLN section had poor vocal function, which improved in 8 patients after medialization of the unilateral vocal fold. CONCLUSIONS:Patients with PTC may have vocal dysfunction from cancer or surgery-related RLNP. Vocal evaluation and management may help improve their vocal function, thus enhancing their quality of life.
Authors: Bryan R Haugen; Erik K Alexander; Keith C Bible; Gerard M Doherty; Susan J Mandel; Yuri E Nikiforov; Furio Pacini; Gregory W Randolph; Anna M Sawka; Martin Schlumberger; Kathryn G Schuff; Steven I Sherman; Julie Ann Sosa; David L Steward; R Michael Tuttle; Leonard Wartofsky Journal: Thyroid Date: 2016-01 Impact factor: 6.568
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Authors: G Giugliano; M Proh; B Gibelli; E Grosso; M Tagliabue; E De Fiori; F Maffini; F Chiesa; M Ansarin Journal: Acta Otorhinolaryngol Ital Date: 2014-02 Impact factor: 2.124