Our Summary
This study looked at a specific complication that can arise after thyroid surgery - recurrent laryngeal nerve paralysis, which can affect a person’s voice and ability to speak. The researchers wanted to understand more about how and why this happens and if there are ways to prevent it. They also looked at how long it takes for the vocal cord movement to improve after this type of paralysis.
They studied 543 patients who had thyroid surgery at Sapporo Medical University Hospital between 2012 and 2021. They looked at a variety of factors that could influence the risk of this paralysis, including the patient’s gender, age, BMI, whether they had cancer, the type of monitoring used during surgery, and the experience of the surgeon.
They found that permanent paralysis of this nerve was quite rare, happening in just 1.7% of cases. Temporary paralysis, however, happened in 14.5% of cases. Interestingly, men and patients who had a specific type of monitoring during surgery (IIONM) had a lower risk of temporary paralysis.
For those who did experience temporary paralysis, the time it took for their vocal cords to start working again varied depending on the type of injury they had during surgery. Minor injuries took about 2.8 months to recover, major injuries took about 4.5 months, and adhesions took about 3.2 months.
The researchers concluded that using IIONM during surgery and being particularly careful during surgery on women could help prevent this type of nerve paralysis. Knowing how long recovery might take for different types of injuries could also help doctors explain the situation to patients and determine the best time to start interventions to improve speech.
FAQs
- What is recurrent laryngeal nerve paralysis and how does it impact a person after thyroid surgery?
- What factors can influence the risk of recurrent laryngeal nerve paralysis after thyroid surgery?
- What measures can be taken to prevent recurrent laryngeal nerve paralysis during thyroid surgery?
Doctor’s Tip
A helpful tip a doctor might tell a patient about vocal cord surgery is to follow post-operative care instructions carefully, including resting the voice and avoiding activities that strain the vocal cords. It is also important to attend follow-up appointments and speech therapy sessions to help with recovery and rehabilitation. Additionally, maintaining good overall health and hydration can support the healing process for the vocal cords.
Suitable For
Patients who are at risk of developing vocal cord paralysis after thyroid surgery may be recommended vocal cord surgery. These patients may include those who have experienced recurrent laryngeal nerve paralysis, which can affect their voice and ability to speak. Factors that may increase the risk of this complication include gender, age, BMI, presence of cancer, type of monitoring used during surgery, and experience of the surgeon.
In cases where temporary paralysis occurs, patients may benefit from vocal cord surgery to help improve their voice and speech. The type of injury sustained during surgery can also impact the time it takes for vocal cords to recover, with minor injuries taking about 2.8 months, major injuries taking about 4.5 months, and adhesions taking about 3.2 months to heal.
Overall, vocal cord surgery may be recommended for patients who have experienced recurrent laryngeal nerve paralysis after thyroid surgery, particularly if the paralysis is affecting their voice and speech. It is important for patients to discuss their individual circumstances with their healthcare provider to determine the best course of treatment.
Timeline
In summary, before vocal cord surgery, a patient may experience symptoms such as hoarseness, difficulty speaking or swallowing, and changes in voice quality. They may undergo diagnostic tests such as laryngoscopy and imaging studies to determine the extent of the vocal cord disorder.
After vocal cord surgery, the patient may experience temporary or permanent changes in voice quality and may need speech therapy to improve vocal function. The recovery timeline can vary depending on the type of injury sustained during surgery, with minor injuries taking around 2.8 months to heal and major injuries taking around 4.5 months.
Overall, the study highlights the importance of factors such as gender, type of monitoring during surgery, and surgeon experience in preventing complications such as recurrent laryngeal nerve paralysis. Understanding the recovery timeline for different types of injuries can also help healthcare providers better manage patient expectations and provide appropriate interventions for speech improvement.
What to Ask Your Doctor
Some questions a patient should ask their doctor about vocal cord surgery include:
- What are the potential risks and complications associated with vocal cord surgery, including the risk of recurrent laryngeal nerve paralysis?
- How experienced is the surgeon in performing vocal cord surgery, and what is their success rate in preventing nerve paralysis?
- Will I undergo intraoperative nerve monitoring (IIONM) during the surgery to help prevent nerve paralysis?
- What is the likelihood of temporary or permanent vocal cord paralysis following the surgery?
- If temporary paralysis does occur, how long does it typically take for the vocal cords to start working again?
- Are there any specific factors, such as gender or age, that could increase my risk of experiencing nerve paralysis during surgery?
- What steps can I take before and after the surgery to optimize my vocal cord function and reduce the risk of complications?
- Are there any alternative treatment options to vocal cord surgery that should be considered?
- How long is the recovery process expected to take, and what can I do to help facilitate healing and improve my voice post-surgery?
- Are there any long-term effects or considerations I should be aware of after vocal cord surgery?
Reference
Authors: Obata K, Kurose M, Kakiuchi A, Takano K. Journal: Auris Nasus Larynx. 2024 Oct;51(5):892-897. doi: 10.1016/j.anl.2024.08.006. Epub 2024 Aug 29. PMID: 39214038