Literature DB >> 19221326

Laryngeal complications after thyroidectomy: is it always the surgeon?

Matthias Echternach1, Christoph A Maurer, Christoph Maurer, Thomas Mencke, Martin Schilling, Thomas Verse, Bernhard Richter.   

Abstract

HYPOTHESIS: Laryngeal dysfunction after thyroidectomy is a common complication. However, few data are available to differentiate whether these complications result from injury to the recurrent nerve or to the vocal folds from intubation.
SETTING: University medical center. PATIENTS: Seven hundred sixty-one patients who underwent surgery to the thyroid gland from 1990 to 2002. Of these patients, 8.4% underwent a revision thyroidectomy. INTERVENTION: Preoperative and postoperative laryngostroboscopic examination. MAIN OUTCOME MEASURE: Laryngostroboscopic evaluation of laryngeal complications.
RESULTS: The overall rate of laryngeal complications was 42.0% (320 patients). Complications from an injury to the vocal folds occurred in 31.3% of patients. Weakness or paresis of the recurrent nerve was initially present in 6.6% and was related to the nerves at risk. This rate was higher in revision thyroidectomies than in primary surgical interventions (6.2% vs 11.6%; P = .04). The rate of laryngeal injuries was higher in patients older than 65 years (39.8% vs 30.8%; P = .03).
CONCLUSIONS: These data suggest that laryngeal complications after thyroidectomies are primarily caused by injury to the vocal folds from intubation and to a lesser extent by injury to the laryngeal nerve. We recommend documentation of informed consent, especially for patients who use their voice professionally, such as singers, actors, or teachers.

Entities:  

Mesh:

Year:  2009        PMID: 19221326     DOI: 10.1001/archsurg.2008.530

Source DB:  PubMed          Journal:  Arch Surg        ISSN: 0004-0010


  21 in total

1.  Recurrent laryngeal nerve and voice preservation: routine identification and appropriate assessment - two important steps in thyroid surgery.

Authors:  Ravindra Singh Mohil; Pragnesh Desai; Nitisha Narayan; Maheswar Sahoo; Dinesh Bhatnagar; V P Venkatachalam
Journal:  Ann R Coll Surg Engl       Date:  2010-08-19       Impact factor: 1.891

Review 2.  [Laryngeal alterations following endotracheal intubation and use of larynx masks].

Authors:  M Echternach; T Mencke; B Richter; A Reber
Journal:  HNO       Date:  2011-05       Impact factor: 1.284

3.  Association Between Age and Patient-Reported Changes in Voice and Swallowing After Thyroidectomy.

Authors:  Zeyad Sahli; Joseph K Canner; Omar Najjar; Eric B Schneider; Jason D Prescott; Jonathon O Russell; Ralph P Tufano; Martha A Zeiger; Aarti Mathur
Journal:  Laryngoscope       Date:  2018-09-07       Impact factor: 3.325

4.  In reply.

Authors:  Nada Rayes; Daniel Seehofer; Peter Neuhaus
Journal:  Dtsch Arztebl Int       Date:  2014-06-20       Impact factor: 5.594

Review 5.  Intraoperative Neuromonitoring in Thyroid Surgery: A Systematic Review.

Authors:  Rhea Malik; Dimitrios Linos
Journal:  World J Surg       Date:  2016-08       Impact factor: 3.352

Review 6.  Morbidity following thyroid surgery: acceptable rates and how to manage complicated patients.

Authors:  M N Minuto; S Reina; E Monti; G L Ansaldo; E Varaldo
Journal:  J Endocrinol Invest       Date:  2019-05-23       Impact factor: 4.256

7.  Recurrent laryngeal nerve injury in thyroid surgery.

Authors:  Hazem M Zakaria; Naif A Al Awad; Ali S Al Kreedes; Abdul Mohsin A Al-Mulhim; Mohammed A Al-Sharway; Maha Abdul Hadi; Ahmed A Al Sayyah
Journal:  Oman Med J       Date:  2011-01

8.  Preoperative ultrasonography assessment of vocal cord movement during thyroid and parathyroid surgery.

Authors:  Shih-Ping Cheng; Jie-Jen Lee; Tsang-Pai Liu; Kuo-Sheng Lee; Chien-Liang Liu
Journal:  World J Surg       Date:  2012-10       Impact factor: 3.352

9.  Postoperative laryngoscopy in thyroid surgery: proper timing to detect recurrent laryngeal nerve injury.

Authors:  Gianlorenzo Dionigi; Luigi Boni; Francesca Rovera; Stefano Rausei; Paolo Castelnuovo; Renzo Dionigi
Journal:  Langenbecks Arch Surg       Date:  2009-12-15       Impact factor: 3.445

10.  Evaluating the incidence, clinical significance and predictors for vocal cord palsy and incidental laryngopharyngeal conditions before elective thyroidectomy: is there a case for routine laryngoscopic examination?

Authors:  Brian Hung-Hin Lang; Kevin Ka-Wan Chu; Raymond King-Yin Tsang; Kai Pun Wong; Birgitta Yee-Hang Wong
Journal:  World J Surg       Date:  2014-02       Impact factor: 3.352

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