Factors Predisposing to Post Thyroidectomy Vocal Cord Paralysis at Ospital ng Maynila Medical Center
Keywords:paralysis, vocal cord, thyroidectomy, recurrent laryngeal nerves, recurrent laryngeal nerve injury
Objective: To determine the prevalence of vocal cord paralysis among post thyroidectomy patients based on severity and laterality, and explore possible associations with age, sex, diagnosis and type of thyroid lesion and surgical procedure.
Design: Cross-sectional study
Setting: Tertiary Government Training Hospital
Participants: Records of patients who underwent thyroidectomy under the Department of Otorhinolaryngology – Head and Neck Surgery of the Ospital ng Maynila Medical Center from January 1, 2014 to June 30, 2021.
Results: There were strong associations between the type of lesion and the presence of recurrent laryngeal nerve injury (V=.211, p=.001) and the diagnosis and the presence of RLNI (V=.245, p=.006). There were no significant associations between patient’s sex, age, diagnosis, type of thyroid lesion, surgical procedure with laterality and severity of RLNI. It was notable that all cases of bilateral recurrent laryngeal nerve injury were due to carcinoma only. Patients with malignant tumors were 2.8x (95% CI: 1.48-5.29) as likely to develop post surgical RLNI than those with benign tumors (p=.0015).
Conclusion: The factors that had a strong association with the presence of vocal cord paralysis among post-thyroidectomy patients were the diagnosis and type of thyroid lesion. Malignant thyroid lesions (specifically thyroid carcinoma) had a higher incidence of recurrent laryngeal nerve injury compared to benign thyroid lesions. More data from different institutions and including other predisposing factors may confirm our findings.
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