ArticleWorld journal of surgery2014
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?
Article in World journal of surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- The 2024 revised clinical guidelines on the management of thyroid tumors by the Japan Association of Endocrine Surgery.Endocrine journal · 2025Guideline
- Paediatric differentiated thyroid carcinoma: a UK National Clinical Practice Consensus Guideline.Endocrine-related cancer · 2022Guideline
- A pre- and post-operative protocol for assessment of voice and swallowing function in patients undergoing heart or lung transplantation.JHLT open · 2025Article
- Observation of changes in quality of life for 5 years after thyroid surgery: an observational cross-sectional study in Korean population.Annals of surgical treatment and research · 2023Article
- Ultrasound prediction for vocal cord dysfunction in patients scheduled for anterior cervical spine surgeries: a prospective cohort study.Journal of clinical monitoring and computing · 2021Article
- Development and validation of the nomogram for predicting preoperative vocal cord palsy in thyroid cancer patients.Gland surgery · 2021Article
- Association of Hypocalcemia and Magnesium Disorders With Thyroidectomy in Commercially Insured Patients.JAMA otolaryngology-- head & neck surgery · 2020Article
- Incidence, Risk Factors, and Natural Outcome of Vocal Fold Paresis in 920 Thyroid Operations with Routine Pre- and Postoperative Laryngoscopic Evaluation.World journal of surgery · 2019Observational
- Evaluation of Vocal Cord Function Before Thyroidectomy: Experience from a Developing Country.The Indian journal of surgery · 2018Article
- Determining the Learning Curve of Transcutaneous Laryngeal Ultrasound in Vocal Cord Assessment by CUSUM Analysis of Eight Surgical Residents: When to Abandon Laryngoscopy.World journal of surgery · 2016Article
- Using Transcutaneous Laryngeal Ultrasonography (TLUSG) to Assess Post-thyroidectomy Patients' Vocal Cords: Which Maneuver Best Optimizes Visualization and Assessment Accuracy?World journal of surgery · 2016Article
- Is there a case for selective, rather than routine, preoperative laryngoscopy in thyroid surgery?Gland surgery · 2015Review
- Flexible Laryngoscopy Findings in Patients Undergoing Thyroidectomy in North-Central Nigeria.Journal of the West African College of SurgeonsArticle
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRoutine preoperative laryngeal examination remains controversial. We aimed to assess the utility of preoperative routine flexible laryngoscopy (FL) by looking at the incidence, clinical significance and predictors for preoperative vocal cord paresis (VCP) and incidental laryngopharyngeal conditions (LPC) in our consecutive cohort.
methodsA total of 302 patients underwent laryngeal examination by an independent otorhinolaryngologist and were specifically asked about voice/swallowing symptoms suggestive of VCP 1 day before surgery. As well as vocal cord (VC) mobility, the naso-pharynx and larynx were examined using FL. Any VCP and/or LPC was recorded. VCP was defined as reduced or absent movement in one or more VC. An LPC was considered clinically significant if the ensuing thyroidectomy was changed or deferred.
resultsSeven (2.3 %) patients had preoperative VCP, while an additional seven patients had an incidental LPC. Of the seven VCPs, five were caused by previous thyroidectomy, while two were caused by a benign goitre. The incidence of asymptomatic VCP in a previously non-operated cohort was 1/245 (0.41 %). Voice/swallowing symptoms (p = 0.033) and previous thyroidectomy (p < 0.001) were the two significant predictors for VCP. The seven incidental LPCs were vallecular cyst (n = 1), VC scar and polyp (n = 2), nasopharyngeal cyst and polyp (n = 3) and redundant arytenoid mucosa (n = 1); however, as they were benign, all seven patients proceeded to thyroidectomy as planned.
conclusionsGiven the low incidence (0.41 %) of asymptomatic VCP in a previously non-operated cohort and that none of the seven LPCs were considered clinically significant, routine preoperative laryngoscopic examination should be reserved for those with previous thyroidectomy and/or voice/swallowing symptoms.
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