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Longitudinal experience of patients with post-thyroidectomy vocal cord paralysis

Published:October 07, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.10.005

      Highlights

      • Routine postoperative patients and those with vocal cord paralysis both report voice symptoms immediately post thyroidectomy.
      • Patients with postoperative vocal cord paralysis have significant morbidity based on objective measures.
      • The majority of patients with vocal cord paralysis recover to baseline function, subjectively and objectively, by 6 months.

      Abstract

      Background

      Prior studies of post-thyroidectomy vocal cord paralysis (VCP) present static and limited evaluations. We comprehensively assessed the experience of patients with VCP post-thyroidectomy over 1 year.

      Methods

      Voice Handicap Index (VHI), Eating Assessment Tool (EAT-10), 12-Item Short Form Survey (SF-12), and qualitative interviews were assessed preoperatively, and 2-weeks, 6-weeks, 6-months, and 1-year postoperatively.

      Outcomes

      7 of 44 patients (15.9%) had postoperative VCP. Compared to those without complication, mean VHI scores for VCP patients increased significantly from baseline at 2-weeks (27.9 point increase vs 1.6, p < 0.01) and 6-weeks (26.3 vs. −0.3, p < 0.01) postoperative. There were no significant differences between groups in SF-12 or EAT-10 scores at any point. Qualitative interviews showed that both groups noted bothersome voice symptoms at 2-weeks; however, by 6-weeks, only VCP patients noted voice symptoms negatively affecting their life.

      Conclusion

      While both patients with and without VCP reported subjective voice symptoms immediately postoperatively, those with VCP had worse quantitative measures. Understanding the longitudinal experience of VCP can help providers tailor counseling for these patients.
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