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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.

References

1Srirompotong, S, Sae-Seow, P, Srirompotong, S. The cause and evaluation of unilateral vocal cord paralysis. J Med Assoc Thai 2001;84:855–8Google ScholarPubMed
2Mehlum, CS, Faber, CE, Grøntved, AM. Vocal fold palsy–etiology and outcome [Danish]. Ugeskr Laeger 2009;12:109–12Google Scholar
3Rowe-Jones, JM, Rosswick, RP, Leighton, SEJ. Benign thyroid disease and vocal cord palsy. Ann R Coll Surg Engl 1993;75:241–4Google ScholarPubMed
4Ko, HC, Lee, LA, Li, HY, Fang, TJ. Etiologic features in patients with unilateral vocal fold paralysis in Taiwan. Chang Gung Med J 2009;32:290–6Google ScholarPubMed
5Bruggink, TP, van der Rijt, AJ, van den Broek, P. Cause, diagnosis and course in 215 patients with vocal cord paralysis [in Dutch]. Ned Tijdschr Geneeskd 1995;139:570–4Google ScholarPubMed
6Maran, AGD. Vocal cord paralysis. In: Maran, AGD, Stell, PM, eds. Clinical Otolaryngology. Oxford: Blackwell Scientific Publications, 1979;406Google Scholar
7Fitzpatrick, PC, Miller, RH. Vocal cord paralysis. J La State Med Soc 1998;150:340–3Google ScholarPubMed
8Slomka, WS, Abedi, E, Sismanis, A, Barlascini, CO. Paralysis of the recurrent laryngeal nerve by an extracapsular thyroid adenoma. Ear Nose Throat J 1989;68:855–63Google ScholarPubMed
9Holl-Allen, RTJ. Laryngeal nerve paralysis and benign thyroid disease. Arch Otolaryngol 1967;85:121–3CrossRefGoogle ScholarPubMed
10Rueger, RG. Benign disease of the thyroid gland and vocal cord paralysis. Laryngoscope 1974;84:897–907CrossRefGoogle ScholarPubMed
11Judd, AF, New, GB, Mann, FC. The effect of trauma upon the laryngeal nerves: an experimental study. Ann Surg 1918;67:257–62CrossRefGoogle ScholarPubMed
12Gani, JS, Morrison, JM. Simple thyroid cyst: cause of acute bilateral recurrent laryngeal nerve palsy. Br Med J 1987;294:1128–9CrossRefGoogle ScholarPubMed
13McCall, AR, Ott, R, Jarosz, H, Lawrence, AM, Paloyan, E. Improvement of vocal cord paresis after thyroidectomy. Am Surg 1987;53:377–9Google ScholarPubMed
14MacLellan, DG, Stephens, DA. Recurrent laryngeal nerve paralysis: compression by a thyroid cyst. Med J Aust 1980;2:450Google ScholarPubMed
15Jatzko, GR, Lisborg, PH, Muller, MG, Wette, VM. Recurrent nerve palsy after thyroid operations–principal nerve identification and a literature review. Surgery 1994;115:139–44Google ScholarPubMed
16Nishida, T, Nakao, K, Hamaji, M, Kamiike, W, Kurozumi, K, Matsuda, H. Preservation of recurrent laryngeal nerve invaded by differentiated thyroid cancer. Ann Surg 1997;226:85–91CrossRefGoogle ScholarPubMed
17Sulica, L. The natural history of idiopathic unilateral vocal fold paralysis: evidence and problems. Laryngoscope 2008;118:1303–7CrossRefGoogle ScholarPubMed