Bilateral Vocal Cord Palsy After Thyroid Surgery: What to Expect?

Jamjoum Alaa; Cho Anna; Lee Narang; Choe Jun-Ho; Kim Jung-Han; Kim Jee Soo

doi:10.16956/jes.2023.23.2.19

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자료유형: 학술저널

저자정보: Jamjoum Alaa (Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.) Cho Anna (Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.) Lee Narang (Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.) Choe Jun-Ho (Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.) Kim Jung-Han (Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.) Kim Jee Soo (Division of Endocrine Surgery Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea.)

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제23권 제2호

발행연도: 2023.6

수록면: 19 - 26 (8page)

DOI: 10.16956/jes.2023.23.2.19

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Purpose: This study aimed to evaluate the natural course of structurally intact bilateral recurrent laryngeal nerve (RLN) injury leading to bilateral vocal cord palsy (VCP) and assess the frequency of the need for tracheostomy following thyroid surgery. Methods: This was a single-institution retrospective review of patients who developed bilateral VCP following open or endoscopic total thyroidectomy between 2003 and 2021. Results: Thirty-four of the 9,066 patients had bilateral RLN injury. Twenty-one patients with structurally intact RLN injuries were included in the study (0.23%): 14 with bilateral vocal cord (VC) paralysis (66.7%) and seven with bilateral VC paresis (33.3%). All patients underwent a total thyroidectomy with central lymph node dissection. The incidence was higher in female patients (66.7%) in their 5th and 6th decade. Final diagnoses included papillary thyroid cancer (52.4%), papillary thyroid microcancer (42.9%), and multinodular goiter (4.8%). The cause of RLN injury was idiopathic in most cases; however, some cases were due to tumor invasion, traction, thermal injury, and traumatic endotracheal intubation. Tracheostomy was required in four patients (19.05%) with bilateral VC paralysis. Complete recovery of the VCs occurred in nine patients (42.9%). In most cases, VC mobility improved within six months. Conclusion: Bilateral VCP caused by structurally intact bilateral RLN injury following thyroid surgery was transient, with a high possibility of complete recovery. The period of VC mobility recovery ranges from one day to nine months, and a mandatory tracheostomy may not be needed unless there is a definite sign of airway obstruction

#Vocal cord palsy #Thyroidectomy #Tracheostomy

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