Vocal fold paralysis in the presence of thyroid disease: management strategies

The presentation of vocal fold palsy with associated goitre has historically been considered to be due to malignancy with recurrent laryngeal nerve involvement. In total, 830 consecutive patients who underwent thyroid surgery were reviewed. Patients with vocal fold paralysis and thyroid disease were...

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Bibliographic Details
Published in:Journal of laryngology and otology 2013-08, Vol.127 (8), p.768-772
Main Authors: O'Duffy, F, Timon, C
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Cohort Studies
Cysts
Female
Histology
Humans
Iatrogenesis
Inflammation
Lymphoma
Main Articles
Male
Middle Aged
Ostomy
Pathology
Patients
Recurrent Laryngeal Nerve - surgery
Retrospective Studies
Thyroid diseases
Thyroid Diseases - complications
Thyroid Diseases - surgery
Thyroid Neoplasms - complications
Thyroidectomy
Tracheotomy
Treatment Outcome
Vocal Cord Paralysis - etiology
Vocal Cord Paralysis - surgery
Vocal Cord Paralysis - therapy
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Summary:The presentation of vocal fold palsy with associated goitre has historically been considered to be due to malignancy with recurrent laryngeal nerve involvement. In total, 830 consecutive patients who underwent thyroid surgery were reviewed. Patients with vocal fold paralysis and thyroid disease were examined to determine the aetiology of the paralysis. Nine patients were identified with new onset vocal fold paralysis prior to thyroid surgery. Six of the patients with recurrent laryngeal nerve paralysis had benign thyroid disease, and for three of the patients the paralysis was secondary to malignancy. Recurrent laryngeal nerve paralysis in the presence of thyroid disease is not pathognomonic for malignancy. The current literature may underestimate the association between vocal fold paralysis and benign thyroid disease. The paper also highlights the importance of recurrent laryngeal nerve preservation in patients who present with palsy and thyroid disease; the relief of benign compression often leads to complete recovery of recurrent laryngeal nerve paralysis.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215113001552