Voice changes after thyroidectomy: role of the external laryngeal nerve.
نویسندگان
چکیده
Hitherto voice changes have been regarded as an infrequent complication of thyroidectomy and damage to the recurrent laryngeal nerve has been given as their major cause. Voice function was assessed in 325 patients after thyroidectomy. Permanent changes occurred in 35 (25%) after subtotal thyroidectomy and in 19 (11%) after lobectomy. The commonest cause of voice change appeared to be injury to the external laryngeal nerves on one or both sides. Damage to the recurrent laryngeal nerve, which was routinely identified and protected, was rarely a cause. When the external laryngeal nerves were identified and preserved, permanent voice changes occurred in only 5% of cases; this was similar to the incidence of 3% in controls after endotracheal intubation alone. The course of the external laryngeal nerve is variable, and consequently mass ligation of the vessels at the top of the upper pole will damage it in a high proportion of cases. To minimise this serious complication these nerves should be identified and protected as well as the recurrent nerves and voice function should be assessed early in the postoperative period by laryngoscopy and by a speech therapist.
منابع مشابه
Improving Voice Outcomes After Injury to the Recurrent Laryngeal Nerve
Objectives: The present study aimed to determine the voice outcomes before and after the administration of voice therapy in patients who suffered an injury to the recurrent laryngeal nerve after undergoing thyroidectomy. Methods: The sample consisted of 26 patients (2 males and 24 females) aged between 18 and 80 years (m=55±12) who experienced injury to the recurrent laryngeal nerve fol...
متن کاملLaryngeal vocal and endoscopic alterations after thyroidectomy under local anesthesia and hypnosedation.
UNLABELLED Vocal alterations after thyroidectomy are generally related to laryngeal nerve injury or laryngotracheal mobility disorders caused by postoperative fibrosis or strap muscle lesion. AIM this study aims to evaluate the frequency of vocal and rima glottidis disorders after thyroidectomy. MATERIALS AND METHOD This is a prospective study based on 35 patients submitted to thyroidectomy...
متن کاملVoice changes after thyroidectomy without recurrent laryngeal nerve injury.
BACKGROUND Injury of the inferior laryngeal nerve is not the only cause of voice alteration after thyroidectomy; many patients notice minimal changes immediately after operation, without evidence of inferior laryngeal nerve damage. We hypothesized that there may be other causes for voice modification, such as injuries of the superior laryngeal nerve, prethyroid strap muscles, and cricothyroid m...
متن کاملPrevention of voice change in singers undergoing thyroidectomy by using a nerve stimulator to identify the external laryngeal nerve.
متن کامل
Prospective randomized study on injury of the external branch of the superior laryngeal nerve during thyroidectomy comparing intraoperative nerve monitoring and a conventional technique.
BACKGROUND The external branch of the superior laryngeal nerve (SLN) is susceptible to injuries during thyroidectomy, causing voice impairment. Intraoperative nerve monitoring may facilitate identification of the nerve, reducing voice impairment. METHODS A total of 252 patients undergoing thyroidectomy were randomly assigned to group N (the NIM-Response 3.0 system was used) or group C (the co...
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عنوان ژورنال:
- British medical journal
دوره 289 6456 شماره
صفحات -
تاریخ انتشار 1984