Preoperative vocal cord paralysis and its association with malignant thyroid disease and other pathological features
نویسندگان
چکیده
BACKGROUND Vocal cord paralysis (VCP) is found in both benign and malignant thyroid disease. This study was performed to determine if the presence of preoperative VCP predicts malignancy. METHODS A retrospective analysis was performed on a cohort of 1923 consecutive patients undergoing thyroid surgery. The incidence of preoperative VCP was recorded. Patient and nodule characteristics were correlated with final pathology. RESULTS 1.3% of our cohort was found to have preoperative VCP. Malignant pathology was discovered in 76% of patients with preoperative VCP. Among these patients, 72% had a left sided paralysis. 10.5% of patients with preoperative VCP had perineural invasion (PNI) on final pathology, compared to 1.1% of patients with normal VC function. CONCLUSION Preoperative VCP appears to be a strong, though not an absolute, indicator of malignancy. Most VCP were on the left side. Assessing for preoperative VCP is crucial in all patients who need thyroid surgery, as even benign nodules can be accompanied by preoperative vocal cord paralysis.
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Vocal fold paralysis in subacute thyroiditis.
Vocal fold paralysis is associated with involvement of the vagus nerve or the recurrent laryngeal nerve between the jugular foramen and the entry point into the larynx. Malignancies of the thyroid are a frequent cause, but vocal fold paralysis is also found in certain benign diseases. In a series of 1,200 cases, the incidence of the association between paralysis and benign thyroid disease was 0...
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