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

Published online by Cambridge University Press:  30 July 2013

F O'Duffy  and
C Timon
F O'Duffy*
Affiliation:
Department of Otolaryngology Head And Neck Surgery, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
C Timon
Affiliation:
Department of Otolaryngology Head And Neck Surgery, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
*
Address for correspondence: Mr F O'Duffy, 22 Woodside Drive, Churchtown, Dublin 14, Ireland E-mail: fergaloduffy@hotmail.com
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Abstract

Background:

The presentation of vocal fold palsy with associated goitre has historically been considered to be due to malignancy with recurrent laryngeal nerve involvement.

Method:

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.

Results:

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.

Conclusion:

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.

Keywords

Recurrent Laryngeal NerveThyroidectomyVocal Cord Paralysis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 8 , August 2013 , pp. 768 - 772
Copyright
Copyright © JLO (1984) Limited 2013 

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Footnotes

Presented orally at the Irish Otolaryngology Society conference, 8–9 October 2010, Enniskillen, Ireland.

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