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Endoscopic laryngeal findings in patients undergoing thyroid and parathyroid surgery

Published online by Cambridge University Press:  26 February 2021

E S Burckardt ,
B J Baird ,
J H Van Stan  and
J A Burns
E S Burckardt
Affiliation:
Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston
B J Baird
Affiliation:
Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston
J H Van Stan
Affiliation:
Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston Department of Communication Sciences, Massachusetts General Hospital Institute of Health Professionals, Boston, USA
J A Burns*
Affiliation:
Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston
*
Author for correspondence: Dr James A Burns, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, 11th floor, 1 Bowdoin Square, Boston, MA02114, USA E-mail: [email protected]
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Abstract

Objectives

This study aimed to report the pre- and post-operative laryngeal endoscopic findings in patients referred by non-otolaryngologists who are undergoing thyroid and/or parathyroid surgery, and to determine the number and nature of referrals before and after the release of the clinical practice guideline for improving voice outcomes after thyroid surgery.

Methods

This retrospective cohort study, conducted at a tertiary care academic hospital, comprised adult patients referred by the endocrine surgery service for laryngoscopy from 2007 to 2018 (n = 166). Data regarding patient demographics, reason for referral and endoscopic findings were recorded.

Results

The number of referrals increased significantly after the release of the practice guideline. The most common indication for referral pre- and post-operatively was voice change. The most common finding during laryngoscopy was normal examination findings (pre-operatively) and unilateral vocal fold immobility (post-operatively).

Conclusion

Peri-operative thyroid and/or parathyroid patients have laryngoscopic findings other than vocal fold immobility. Laryngoscopy to detect structural and functional pathology is warranted.

Keywords

ThyroidParathyroid GlandsLaryngoscopyPreoperative PeriodPostoperative PeriodLarynxVocal Fold DysfunctionVoice
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 3 , March 2021 , pp. 264 - 268
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr J A Burns takes responsibility for the integrity of the content of the paper

References

Chandrasekhar, SS, Randolph, GW, Seidman, MD, Rosenfeld, RM, Angelos, P, Barkmeier-Kraemer, J et al. . Clinical practice guideline: improving voice outcomes after thyroid surgery. Otolaryngol Head Neck Surg 2013;148(6 suppl):S1–37CrossRefGoogle ScholarPubMed
Chambers, KJ, Bhattacharyya, N. The increasing role of otolaryngology in the management of surgical thyroid disorders. Laryngoscope 2013;123:3239–42CrossRefGoogle ScholarPubMed
Farrag, TY, Samlan, RA, Lin, FR, Tufano, RP. The utility of evaluating true vocal fold motion before thyroid surgery. Laryngoscope 2006;116:235–8CrossRefGoogle ScholarPubMed
Cohen, SM, Dupont, WD, Courey, MS. Quality-of-life impact of non-neoplastic voice disorders: a meta-analysis. Ann Otol Rhinol Laryngol 2006;115:128–34CrossRefGoogle ScholarPubMed
Brodnitz, FS. Goals, results and limitations of vocal rehabilitation. Arch Otolaryngol 1963;77:148–56CrossRefGoogle ScholarPubMed
Lancer, JM, Syder, D, Jones, AS, Le Boutillier, A. Vocal cord nodules: a review. Clin Otolaryngol Allied Sci 1988;13:43–51CrossRefGoogle ScholarPubMed
Morrison, MD, Nichol, H, Rammage, LA. Diagnostic criteria in functional dysphonia. Laryngoscope 1986;96:1–8CrossRefGoogle ScholarPubMed
Haugen, BR, Alexander, EK, Bible, KC, Doherty, GM, Mandel, SJ, Nikiforov, YE et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016;26:1–133CrossRefGoogle ScholarPubMed
Lorenz, K, Abuazab, M, Sekulla, C, Schneider, R, Nguyen Thanh, P, Dralle, H. Results of intraoperative neuromonitoring in thyroid surgery and preoperative vocal cord paralysis. World J Surg 2014;38:582–9110.1007/s00268-013-2402-1CrossRefGoogle ScholarPubMed
Sittel, C, Stennert, E, Thumfart, WF, Dapunt, U, Eckel, HE. Prognostic value of laryngeal electromyography in vocal fold paralysis. Arch Otolaryngol Head Neck Surg 2001;127:155–60CrossRefGoogle ScholarPubMed
Musholt, TJ, Clerici, T, Dralle, H, Frilling, A, Goretzki, PE, Hermann, MM et al. German Association of Endocrine Surgeons practice guidelines for the surgical treatment of benign thyroid disease. Langenbecks Arch Surg 2011;396:639–49CrossRefGoogle ScholarPubMed
Heller, KS. A new tool: the same dilemma. Surgery 2013;154:1156–7CrossRefGoogle ScholarPubMed
Wong, KP, Au, KP, Lam, S, Lang, BH. Lessons learned after 1000 cases of transcutaneous laryngeal ultrasound (TLUSG) with laryngoscopic validation: is there a role of TLUSG in patients indicated for laryngoscopic examination before thyroidectomy? Thyroid 2017;27:88–94CrossRefGoogle Scholar
Kavookjian, H, Holcomb, A, Garnett, JD, Kraft, S. The role of quality-of-life instruments in predicting voice therapy dropout. Laryngoscope 2018;128:2832–7CrossRefGoogle ScholarPubMed
Friedman, AD, Hillman, RE, Landau-Zemer, T, Burns, JA, Zeitels, SM. Voice outcomes for photoangiolytic KTP laser treatment of early glottic cancer. Ann Otol Rhinol Laryngol 2013;122:151–8CrossRefGoogle ScholarPubMed