Our Summary

This research paper examined whether having vocal cord paralysis (VCP) before thyroid surgery indicates a risk of cancer. The study analyzed data from 1923 patients who had thyroid surgery, focusing on those who had VCP before their operation. They found that 1.3% of these patients had VCP before surgery, and 76% of this group were later found to have cancer. Most of these patients had paralysis on the left side. Also, 10.5% of patients with VCP before surgery had cancer cells spread along the nerves, compared to only 1.1% among those without VCP. The researchers conclude that having VCP before thyroid surgery could be a strong sign of cancer, so it’s crucial for all patients who need thyroid surgery to be checked for VCP. However, they note that even non-cancerous lumps can cause VCP.

FAQs

  1. Does having vocal cord paralysis (VCP) before thyroid surgery indicate a higher risk of cancer?
  2. What percentage of patients with vocal cord paralysis before thyroid surgery were found to have cancer?
  3. Should all patients who need thyroid surgery be checked for vocal cord paralysis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vocal cord surgery is to follow all post-operative care instructions carefully to ensure proper healing and recovery. This may include avoiding excessive talking or singing, staying hydrated, and attending follow-up appointments with your healthcare provider. It’s also important to communicate any concerns or changes in your voice to your doctor promptly.

Suitable For

Patients who are typically recommended vocal cord surgery include those with:

  1. Vocal cord paralysis: Patients with vocal cord paralysis may experience difficulty breathing, swallowing, or speaking due to the inability of the vocal cords to move properly. Surgery may be recommended to improve vocal cord function and alleviate symptoms.

  2. Vocal cord nodules or polyps: Vocal cord nodules and polyps are noncancerous growths on the vocal cords that can cause hoarseness, difficulty speaking, and vocal fatigue. Surgery may be recommended to remove these growths and improve vocal function.

  3. Vocal cord cancer: Patients with vocal cord cancer may require surgery to remove the cancerous tissue and prevent the spread of the disease. Surgery may be combined with other treatments such as radiation therapy or chemotherapy.

  4. Recurrent laryngeal nerve injury: Damage to the recurrent laryngeal nerve, which controls the movement of the vocal cords, can result in vocal cord paralysis. Surgery may be recommended to repair the nerve and restore vocal cord function.

  5. Laryngeal stenosis: Laryngeal stenosis is a narrowing of the airway in the larynx that can cause difficulty breathing. Surgery may be recommended to widen the airway and improve breathing.

Overall, patients experiencing vocal cord dysfunction or other conditions affecting vocal cord function may be recommended for vocal cord surgery to improve their quality of life and restore vocal function.

Timeline

Before vocal cord surgery:

  1. Patient experiences symptoms such as hoarseness, vocal fatigue, difficulty speaking or swallowing, and changes in voice quality.
  2. Patient undergoes diagnostic tests such as laryngoscopy, CT scan, or MRI to determine the cause of vocal cord dysfunction.
  3. Patient consults with an otolaryngologist (ear, nose, and throat specialist) to discuss treatment options, including vocal cord surgery.
  4. Patient undergoes pre-operative evaluations and tests to assess their overall health and readiness for surgery.

After vocal cord surgery:

  1. Patient undergoes vocal cord surgery, which may involve procedures such as vocal cord injection, medialization laryngoplasty, or laser surgery to repair or improve vocal cord function.
  2. Patient experiences post-operative symptoms such as temporary hoarseness, throat pain, and difficulty speaking or swallowing.
  3. Patient follows post-operative care instructions provided by their healthcare team, including voice rest, vocal exercises, and follow-up appointments.
  4. Patient undergoes vocal rehabilitation therapy to help improve voice quality and vocal function after surgery.
  5. Patient gradually resumes normal voice use and activities, with ongoing monitoring by their healthcare team to ensure optimal vocal cord function and recovery.

What to Ask Your Doctor

  1. What is the reason for recommending vocal cord surgery in my case?
  2. What are the potential risks and complications associated with vocal cord surgery?
  3. What is the success rate of this type of surgery for my condition?
  4. What is the recovery process like after vocal cord surgery?
  5. Will I need speech therapy or other forms of rehabilitation after the surgery?
  6. Are there any alternative treatment options to consider before proceeding with surgery?
  7. How long will it take for me to regain full function of my vocal cords after the surgery?
  8. Are there any long-term effects or limitations I should be aware of following vocal cord surgery?
  9. How often will I need to follow up with you after the surgery?
  10. Are there any lifestyle changes or precautions I should take to protect my vocal cords post-surgery?

Reference

Authors: Kay-Rivest E, Mitmaker E, Payne RJ, Hier MP, Mlynarek AM, Young J, Forest VI. Journal: J Otolaryngol Head Neck Surg. 2015 Sep 11;44(1):35. doi: 10.1186/s40463-015-0087-1. PMID: 26362432