Risk factors for thyroid surgery–related unilateral vocal fold paralysis

Hung Chun Chen, Yu Cheng Pei, Tuan Jen Fang*

*此作品的通信作者

研究成果: 期刊稿件文章同行評審

12 引文 斯高帕斯(Scopus)

摘要

Objectives/Hypothesis: We aimed to identify the risk factors for iatrogenic unilateral vocal fold paralysis (UVFP) caused by thyroid surgery, to allow the identification of patients requiring nerve-protection procedures and monitoring technologies. Study Design: Retrospective case study in a medical center. Methods: Patients who underwent thyroid surgery from April 2011 to February 2016 and who were diagnosed with UVFP by laryngoscopy and laryngeal electromyography were included. Patient demographics, types of surgery, and characteristics of the thyroid lesions were analyzed. Results: Sixty (2.1%) of 2,815 patients who received thyroid surgery developed UVFP. The risk of UVFP was higher in patients over 60 years old (odds ratio, 1.89; 95% confidence interval, 1.01-3.26; P =.01). Involvement of the external branch of superior laryngeal nerve (EBSLN) occurred in 19 (31.7%) of the 60 UVFP patients, and was more likely to occurr in patients with diabetes mellitus (odds ratio, 14.19; 95% confidence interval, 3.80-52.94; P <.001). The incidence of UVFP and involvement of the EBSLN differed among surgery types, and was the highest among patients undergoing total thyroidectomy with neck dissection (TTND) (10/158, 6.3% and 5/158, 3.2%, respectively). Conclusions: The risk of thyroid surgery–related UVFP is higher in older patients. EBSLN involvement is more likely in patients with diabetes mellitus. TTND is associated with higher risks of UVFP and EBSLN injury than other types of surgery, implying the need of intraoperative nerve monitoring in these high-risk characteristics. Level of Evidence: 4 Laryngoscope, 129:275–283, 2019.

原文英語
頁(從 - 到)275-283
頁數9
期刊Laryngoscope
129
發行號1
DOIs
出版狀態已出版 - 01 2019

文獻附註

Publisher Copyright:
© The Authors. The Laryngoscope published by Wiley Periodicals, Inc. on behalf of The American Laryngological, Rhinological and Otological Society, Inc.

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