Preview

Endocrine Surgery

Advanced search

Is it advisable to perform preoperativelaryngoscopy in all patients due to undergo the thyroid and parathyroid surgery?Analysis of 5172 preoperative laryngoscopies

Abstract

Given the yearly growth of thyroid and parathyroid surgery, diagnosis of such serious complications as paresis of the larynx is still relevant today. Endoscopic laryngoscopy is the main method of controlling laryngeal function. The timely detection of violations of this function in the postoperative period allows for patients to be sent to specialists quickly for treatment. Nonetheless, the role of laryngoscopies in the preoperative period has not been precisely recognized. The main contentious issue has become the need to perform preoperative laryngoscopies on all patients due to undergo operations on the thyroid or parathyroid glands.For this paper, we analyzed 5172 consecutive endoscopic laryngoscopies. The role of preoperative laryngoscopy when planning surgery on the thyroid or parathyroid glands was determined.

Aim: to evaluate the feasibility of performing routine laryngoscopies on patients due to undergo surgery for diseases of the thyroid and parathyroid glands.

Materials and Methods

This paper presents an analysis of the results of preoperative laryngoscopy on 5172 patients who underwent surgical procedures on the thyroid and parathyroid glands.

Results

Preoperative one-sided paresis of the larynx was detected in 12 (0.23%) of the 5172 patients. Patients did not exhibit bilateral paresis of the larynx.

Conclusions

Preoperative paresis of the larynx is rare, and performing routine endoscopic laryngoscopies on all patients due to undergo thyroid or parathyroid gland operations is not appropriate.

About the Authors

V. A. Makarin
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


A. A. Uspenskaya
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


N. I. Timofeeva
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


I. V. Sleptсov
University hospital of Saint-Petersburg State University; Saint-Petersburg State University
Russian Federation
MD, PhD
Competing Interests:
 


A. A. Semenov
University hospital of Saint-Petersburg State University; Saint-Petersburg State University
Russian Federation
MD, PhD


R. A. Chernikov
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


I. K. Chinchuk
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


U. V. Karelina
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


K. U. Novokshonov
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


E. A. Fedorov
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


Y. N. Malugov
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


V. F. Rusakov
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


P. S. Kniazeva
Saint-Petersburg State Pediatriс Medical University
Russian Federation
MD, PhD


V. A. Malkov
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


T. S. Pridvigkina
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


E. A. Valdina
University hospital of Saint-Petersburg State University
Russian Federation
MD, PhD


Y. N. Fedotov
University hospital of Saint-Petersburg State University; Northern-Western State Mechnicov Medical University
Russian Federation
MD, PhD


A. N. Bubnov
University hospital of Saint-Petersburg State University; Northern-Western State Mechnicov Medical University; Saint-Petersburg State University
Russian Federation
MD, PhD


References

1. Chiang FY, Wang LF, Huang YF, et al. Recurrent laryngeal nerve palsy after thyroidectomy with routine identification of the recurrent laryngeal nerve. Surgery. 2005;137(3):342-347. doi: 10.1016/j.surg.2004.09.008.

2. Shaha AR. Routine laryngoscopy in thyroid surgery: A valuable adjunct. Surgery. 2007;142(6):865-866. doi: 10.1016/j.surg.2007.09.007.

3. Holinger LD, Holinger PC, Holinger PH. Etiology of bilateral abductor vocal cord paralysis: a review of 389 cases. Ann Otol Rhinol Laryngol. 1976;85(4):428-36. doi: 10.1177/000348947608500402

4. Bergenfelz A, Jansson S, Kristoffersson A, et al. Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients. Langenbecks Arch Surg. 2008;393:667-73. doi: 10.1007/s00423-008-0366-7

5. Hodin R, Clark O, Doherty G, et al. Voice issues and laryngoscopy in thyroid surgery patients. Surgery. 2013;154(1):46-47. doi: 10.1016/j.surg.2013.04.014

6. Randolph GW. The importance of pre- and postoperative laryngeal examination for thyroid surgery. Thyroid. 2010;(20):453-458. doi: 10.1089/thy.2010.1632

7. Randolph GW, Kamani D. The importance of preoperative laryngoscopy in patients undergoing thyroidectomy: voice, vocal cord function, and the preoperative detection of invasive thyroid malignancy. Surgery. 2006;139(3):357-62. doi: 10.1016/j.surg.2005.08.009

8. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133. doi: 10.1089/thy.2015.0020.

9. Sittel C, Stennert E, Thumfart WF, et al. Prognostic value of laryngeal electromyography in vocal fold paralysis. Arch Otolaryngol Head Neck Surg. 2001;127:155-60. doi: 10.1001/archotol.127.2.155

10. Franch-Arcas G, González-Sánchez C, Aguilera-Molina YY, et al. Is there a case for selective, rather than routine, preoperative laryngoscopy in thyroid surgery? Gland Surgery. 2015;4(1):8-18. doi: 10.3978/j.issn.2227-684X.2015.01.04.

11. Järhult J, Lindestad PA, Nordenström J, et al. Routine examination of the vocal cords before and after thyroid and parathyroid surgery. Br J Surg. 1991;78:1116-1117.doi: 10.1002/bjs.1800780927

12. Yeung P, Erskine C, Mathews P, et al. Voice changes and thyroid surgery: is pre-operative indirect laryngoscopy necessary? Aust N Z J Surg 1999;69:632-4. doi: 10.1046/j.1440-1622.1999.01653.x

13. Schlosser K, Zeuner M, Wagner M, et al. Laryngoscopy in thyroid surgery—essential standard or unnecessary routine? Surgery. 2007;142(6):858-864.e852. doi: 10.1016/j.surg.2007.09.008.

14. Lee CY, Long KL, Eldridge RJ, et al. Preoperative laryngoscopy in thyroid surgery: Do patients' subjective voice complaints matter? Surgery. 2014;156(6):1477-1483. doi: 10.1016/j.surg.2014.08.038.

15. Smallridge RC, Ain KB, Asa SL, et al. American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer. Thyroid. 2012;22(11):1104-1139. doi: 10.1089/thy.2012.0302.

16. Dralle H, Musholt TJ, Schabram J, et al. German Association of Endocrine Surgeons practice guideline for the surgical management of malignant thyroid tumors. Langenbeck's Archives of Surgery. 2013;398(3):347-375. doi: 10.1007/s00423-013-1057-6.

17. Takami H, Ito Y, Noguchi H, et al. eds. Treatment of thyroid tumor. Japanese clinical guidelines. 2013 ed. Tokyo: Springer Japan; 2013.

18. Pacini F, Schlumberger M, Dralle H, et al. European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol.2006;154(6):787-803. doi: 10.1530/eje.1.02158.

19. Ванушко В.Э., Бельцевич Д.Г., Мельниченко Г.А., и др. Проект: Клинические рекомендации Российской ассоциации эндокринологов. // Эндокринная хирургия. – 2015. – Т. 9.–№1 – С. 15-33. [Vanushko VE, Beltsevich DG, Mel'nichenko GA, et al. DRAFT: Russian Association of Endocrinologists Clinic Guidelines for Thyroid Nodules Diagnostic and Treatment. Endocrine Surgery. 2015;9(1):15-21. (In Russ.)] doi:10.14341/serg2015115-21

20. Бельцевич Д.Г., Ванушко В.Э., Мельниченко Г.А., и др. В Российские клинические рекомендации по диагностике и лечению дифференцированного рака щитовидной железы у взрослых. Проект. Редакция 2016г. // Эндокринная хирургия. -2015. –Т. 9. – №3 – С. 7-14. [Bel'tsevich DG, Vanushko VE, Mel'nichenko GA, et. al. Russian clinical practice guidelines for diagnosis and treatment of differentiated thyroid cancer. Endocrine Surgery. 2015;(3):7-14. (In Russ).] doi: 10.14341/serg201537-14

21. Myssiorek D. Recurrent laryngeal nerve paralysis: anatomy and etiology. Otolaryngol Clin North Am. 2004;37(1):25-44. doi: 10.1016/s0030-6665(03)00172-5.

22. Sancho JJ, Pascual‐Damieta M, Pereira JA, et al. Risk factors for transient vocal cord palsy after thyroidectomy. Br J Surg. 2008;95(8):961-967. doi: 10.1002/bjs.6173.

23. Schlosser K, Maschuw K, Hassan I, et al. Are diabetic patients at a greater risk to develop a vocal fold palsy during thyroid surgery than nondiabetic patients? Surgery. 2008;143(3):352-358. doi: 10.1016/j.surg.2007.10.003.

24. Goretzki PE, Schwarz K, Brinkmann J, et al. The Impact of Intraoperative Neuromonitoring (IONM) on Surgical Strategy in Bilateral Thyroid Diseases: Is it Worth the Effort? World J Surg. 2010;34(6):1274-1284. doi: 10.1007/s00268-009-0353-3.

25. Farrag TY, Samlan RA, Lin FR, Tufano RP. The Utility of Evaluating True Vocal Fold Motion Before Thyroid Surgery. Laryngoscope. 2006;116(2):235-238. doi: 10.1097/01.mlg.0000191472.02720.1f.

26. Chan WF, Lo CY, Lam KY, et al. Recurrent laryngeal nerve palsy in well-differentiated thyroid carcinoma: clinicopathologic features and outcome study. World J Surg. 2004;28:1093-8. doi: 10.1007/s00268-004-7419-z

27. Roh JL, Yoon YH, Park CI.. Recurrent laryngeal nerve paralysis in patients with papillary thyroid carcinomas: evaluation and management of resulting vocal dysfunction. Am J Surg 2009;197:459-65. doi: 10.1016/j.amjsurg.2008.04.017


Supplementary files

Review

For citations:


Makarin V.A., Uspenskaya A.A., Timofeeva N.I., Sleptсov I.V., Semenov A.A., Chernikov R.A., Chinchuk I.K., Karelina U.V., Novokshonov K.U., Fedorov E.A., Malugov Y.N., Rusakov V.F., Kniazeva P.S., Malkov V.A., Pridvigkina T.S., Valdina E.A., Fedotov Y.N., Bubnov A.N. Is it advisable to perform preoperativelaryngoscopy in all patients due to undergo the thyroid and parathyroid surgery?Analysis of 5172 preoperative laryngoscopies. Endocrine Surgery. 2015;9(4):5-11. (In Russ.)

Views: 1107


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2306-3513 (Print)
ISSN 2310-3965 (Online)