OUTCOMES OF PRIMARY THYROIDECTOMY WITH PREOPERATIVE UNILATERAL VOCAL CORD PARALYSIS

Objectives: This study investigated recovery of unilateral vocal cord paralysis after thyroidectomy.

Study Design: Retrospective study.

Methods: Medical records of all consecutive patients who underwent primary bilateral thyroidectomy were reviewed. Of these patients, those who had a symptomatic vocal cord paralysis preoperatively were selected. The association between preoperative vocal fold paralysis and pathology, clinical features, and treatment results were analyzed.

Results: 18 patients were included in this study. The population was equally divided between males and females. All had undergone an ultrasound, while 28% and 23% had undergone a CT scan and MRI respectively. Laryngoscopy has shown a right sided and a left one vocal cord paralysis in 61% and 39% of the cases respectively. In one patient, the recurrent laryngeal nerve was sacrificed to reach an R0 resection. The final pathology showed benign and malignant pathologies in 17% and 83% of cases respectively. The overall recovery rate of vocal fold function was 6%. Recovery of a normal function of the vocal cords was seen in 33% and 0% with benign and malignant pathologies respectively.

Conclusions: In thyroid disease, vocal cord paralysis is more common in malignant as compared to benign pathologies. Laryngoscopy and imaging studies are important when planning surgery. Recovery of the normal function is possible and underlines the importance of preserving the affected nerve.