Evidence map›Paper›PMID 25713775›Full record

ReviewGland surgery2015

Is there a case for selective, rather than routine, preoperative laryngoscopy in thyroid surgery?

Guzmán Franch-Arcas, Carmen González-Sánchez, Yari Yuritzi Aguilera-Molina, Orlando Rozo-Coronel, José Santiago Estévez-Alonso, Ángel Muñoz-Herrera

Abstract readReview
In one paragraph

Review in Gland surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Guzmán Franch-Arcas1 Department of Surgery, 2 Department of Otorhinolaryngology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
Carmen González-Sánchez1 Department of Surgery, 2 Department of Otorhinolaryngology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
Yari Yuritzi Aguilera-Molina1 Department of Surgery, 2 Department of Otorhinolaryngology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
Orlando Rozo-Coronel1 Department of Surgery, 2 Department of Otorhinolaryngology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
José Santiago Estévez-Alonso1 Department of Surgery, 2 Department of Otorhinolaryngology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
Ángel Muñoz-Herrera1 Department of Surgery, 2 Department of Otorhinolaryngology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccording to some authors, routine preoperative laryngoscopy should be the standard of care in all patients undergoing thyroid surgery. The rationale for this approach is (I) the risk that a patient has a preoperative vocal cord palsy (VCP) without symptoms; (II) the presence of VCP preoperatively is suggestive of invasive malignancy; (III) it is relevant for the use of intraoperative nerve monitoring; and (IV) surgical strategy may be better defined if a paralysed vocal cord is detected preoperatively.

methodsThis is a review of studies of patients who underwent routine preoperative laryngoscopy to anticipate preoperative VCP and that evaluated related risk factors, including previous surgery, voice function complaints, and a diagnosis of malignancy. The estimated risk of sustaining preoperative VCF in the absence of these factors was determined. The relevant current guidelines from different professional bodies are also addressed.

resultsThe level of evidence that supports routine preoperative laryngoscopy is weak. The risk of harboring preoperative VCP in the absence of previous neck or other risk-related surgery, advanced malignancy or voice symptoms is very low (0.5% of cases).

conclusionsSelective rather than routine use of preoperative laryngoscopy may be acceptable provided that the risk of undetected paralysis is as low as can be reasonably ascertained from the available literature.

Indexed as

Laryngoscopypreoperative periodthyroidectomyvocal cord paralysis

Identifiers

PMID25713775
PMCPMC4321054

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.