Factors Predicting the Recovery of Unilateral Vocal Fold Paralysis After Thyroidectomy

Choi, Yeon-Jik; Joo, Young‐Hoon; Park, Young-Hak; Kim, Sang-Yeon; Sun, Dong‐Il

doi:10.1007/s00268-017-4440-6

Cited by 9 publications

(10 citation statements)

References 29 publications

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“…19,20 In a recent study that investigated factors concerning the recovery of vocal fold paralysis after thyroidectomy, a small tumor size also correlated significantly with the recovery from UVP. 21 (Maybe these factors and also the impact of a cancerous histology or recurrent surgery did not meet statistical significance in our study, due to our sample size. )…”

Section: Clinical Parameters Like Young Age and Short Surgery Time Armentioning

confidence: 72%

Quality of Voice and Prognostic Markers for the Recovery of Vocal Fold Paralysis After Thyroid Surgery

Reiter

Heyduck

Hoffmann

et al. 2019

Ann Otol Rhinol Laryngol

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Objectives: This study is set to analyze clinicopathological factors predicting the recovery of unilateral vocal fold paralysis (UVP) in patients after thyroid gland surgery. The quality of voice was additionally assessed in these patients. Methods: The charts and videolaryngostroboscopy (VLS) examinations of 84 consecutive patients with a complete UVP after surgery of the thyroid gland were retrospectively reviewed. Patients were divided into 2 groups: patients who fully recovered from vocal fold paralysis and those who failed to recover after a follow-up of 12 months. The quality of voice was analyzed among other things by determining the Voice Handicap Index (VHI). Results: The UVP fully recovered in 52 of 84 (61.9%) patients. Positive mucosal waves (pMWs) on the paralyzed side, a minimal glottic gap <3 mm seen at the first postoperative VLS, age ≤50 years, and surgery duration ≤120 minutes were associated factors for a complete recovery of nerve function. The voice parameters improved independently from recovery of the paralysis in 90% of the patients. Conclusions: For patients with a poor prognosis of a UVP, early intervention may be beneficial. Thus, predicting factors for a full recovery of vocal fold motion would be a valuable tool. In our cohort, about 60% of recoveries could have been predicted using the above-mentioned parameters. Good quality of voice was independently reached in 90% of the cases.

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Section: Clinical Parameters Like Young Age and Short Surgery Time Armentioning

confidence: 72%

Quality of Voice and Prognostic Markers for the Recovery of Vocal Fold Paralysis After Thyroid Surgery

Reiter

Heyduck

Hoffmann

et al. 2019

Ann Otol Rhinol Laryngol

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“…While Choi et al showed that the absence of compensatory movement of the normal vocal fold is a positive predictor for recovery and a maximum phonation time of 6.86 is the optimal cutoff value for recovery, Pantvaidya et al did not find any factors that predict recovery. 4,5 Joliat et al found that median recovery time was 8 weeks for transient paralysis and that intra-operative RLN injury such as stretching and sectioning was a factor for permanent paralysis. 6 Nimodipine, a calcium channel blocker, recently emerged as an agent that may improve nerve recovery following injury.…”

Section: Introductionmentioning

confidence: 99%

Recurrent Laryngeal Nerve Paralysis Following Thyroidectomy: Analysis of Factors Affecting Nerve Recovery

et al. 2022

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Objectives: Paralysis of the recurrent laryngeal nerves (RLNs), albeit decreased over the years, leaves the surgeon helpless as there is not much that can be done once it occurs. Nimodipine has been suggested as a remedy that could accelerate the recovery of the nerve. Our study aimed to examine the factors that affect the recovery rate (RR) and time to recovery (TTR) of post-thyroidectomy RLN paralysis, with an emphasis on the use of nimodipine.Methods: A total of 197 patients who had undergone thyroid and parathyroid surgeries were retrospectively reviewed from October 2016 to August 2019. Patients who had RLN paralysis following surgery were assessed. The medical records were retrospectively analyzed to look for possible factors that may influence RLN recovery.Results: A total of 289 nerves were at risk. Temporary RLN paralysis rate was 7.9% while 1.7% was permanent. Age (odds ratio [OR] = 4.8) and intra-operative extra-thyroid extension (OR = 9.0) were independent risk factors for RLN paralysis. The rate of recovery was 82.1%. Loss of signal (LOS; P = .066) was a factor trending for an impact on RR but not nimodipine (P > .05). The mean TTR was 32 days. LOS, nimodipine, and steroid use, among others, were factors trending for an impact on the TTR. Conclusion:Although not reaching statistical significance, nimodipine and steroids might influence TTR but not the RR. Larger studies are warranted to address the effect of nimodipine on the outcome of RLN paralysis.

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“…Also, they were conducted only in hospital services in the Southeast 11,18,20 , Northeast 17,19 , or South Regions 21 of Brazil, with questionnaires whose psychometric properties are unknown [17][18][19][20][21] or not specific to this population 11 . The Thyroidectomy-Related Voice Questionnaire (TVQ) 6,25 has been internationally used with this purpose 6,7,23,[25][26][27][28][29] and already has a translated and transculturally adapted version in Brazilian Portuguese 30 .…”

Section: Introductionmentioning

confidence: 99%

Voice- and swallowing-related symptoms after total thyroidectomy: evidence from a Brazilian national survey

et al. 2021

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Purpose: to estimate the prevalence of voice- and swallowing-related symptoms in women submitted to total thyroidectomy. Methods: a population-based, observational, cross-sectional, analytical study, based on a Brazilian national survey. A total of 252 women, aged 18 to 58 years, submitted to total thyroidectomy, residing in the five geographical regions of the country participated in the study. All of them answered the version of the Thyroidectomy-Related Voice Questionnaire translated and adapted into Brazilian Portuguese, besides questions on demographic and clinical issues. A descriptive analysis of the categorical and quantitative variables was conducted. The relationship between the total TVQ score and the independent variables was analyzed with the Mann-Whitney and Kruskal-Wallis tests. The significance level used was 5%. Results: the most prevalent symptoms were, tired voice, after talking for a long time (50%), and dry mouth/thirst (43.3%). The voice-related symptoms were more prevalent than those related to swallowing. The total TVQ score was not related to age group (p=0.141), profession (p=0.213), region of residence (p=0.303), time since surgery (p=0.955), and radiotherapy/radioiodine therapy (p=0.666). Conclusion: Brazilian women submitted to total thyroidectomy have a high prevalence of voice- and swallowing-related symptoms, the former being predominant.

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Factors Predicting the Recovery of Unilateral Vocal Fold Paralysis After Thyroidectomy

Abstract: Compensatory movement of the normal side evident on videostroboscopy was a poor prognostic factor. Voice analysis can be helpful in counseling vocal fold paralysis patients after thyroidectomy, and early intervention may be considered in patients who are expected to have a poor prognosis.

Cited by 9 publications

References 29 publications

Quality of Voice and Prognostic Markers for the Recovery of Vocal Fold Paralysis After Thyroid Surgery

Quality of Voice and Prognostic Markers for the Recovery of Vocal Fold Paralysis After Thyroid Surgery

Recurrent Laryngeal Nerve Paralysis Following Thyroidectomy: Analysis of Factors Affecting Nerve Recovery

Voice- and swallowing-related symptoms after total thyroidectomy: evidence from a Brazilian national survey

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