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Article: Evaluating the incidence, clinical significance and predictors for vocal cord palsy and incidental laryngopharyngeal conditions before elective thyroidectomy: is there a case for routine laryngoscopic examination?

TitleEvaluating the incidence, clinical significance and predictors for vocal cord palsy and incidental laryngopharyngeal conditions before elective thyroidectomy: is there a case for routine laryngoscopic examination?
Authors
Issue Date2014
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal of Surgery, 2014, v. 38 n. 2, p. 385-391 How to Cite?
AbstractBackground: Routine preoperative laryngeal examination remains controversial. We aimed to assess the utility of preoperative routine flexible laryngoscopy (FL) by looking at the incidence, clinical significance and predictors for preoperative vocal cord paresis (VCP) and incidental laryngopharyngeal conditions (LPC) in our consecutive cohort. Methods: A total of 302 patients underwent laryngeal examination by an independent otorhinolaryngologist and were specifically asked about voice/swallowing symptoms suggestive of VCP 1 day before surgery. As well as vocal cord (VC) mobility, the naso-pharynx and larynx were examined using FL. Any VCP and/or LPC was recorded. VCP was defined as reduced or absent movement in one or more VC. An LPC was considered clinically significant if the ensuing thyroidectomy was changed or deferred. Results: Seven (2.3 %) patients had preoperative VCP, while an additional seven patients had an incidental LPC. Of the seven VCPs, five were caused by previous thyroidectomy, while two were caused by a benign goitre. The incidence of asymptomatic VCP in a previously non-operated cohort was 1/245 (0.41 %). Voice/swallowing symptoms (p = 0.033) and previous thyroidectomy (p < 0.001) were the two significant predictors for VCP. The seven incidental LPCs were vallecular cyst (n = 1), VC scar and polyp (n = 2), nasopharyngeal cyst and polyp (n = 3) and redundant arytenoid mucosa (n = 1); however, as they were benign, all seven patients proceeded to thyroidectomy as planned. Conclusions: Given the low incidence (0.41 %) of asymptomatic VCP in a previously non-operated cohort and that none of the seven LPCs were considered clinically significant, routine preoperative laryngoscopic examination should be reserved for those with previous thyroidectomy and/or voice/swallowing symptoms. © 2013 Société Internationale de Chirurgie.
Persistent Identifierhttp://hdl.handle.net/10722/191515
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLang, HHBen_US
dc.contributor.authorChu, KKen_US
dc.contributor.authorTsang, RKYen_US
dc.contributor.authorWong, KPen_US
dc.contributor.authorWong, BYen_US
dc.date.accessioned2013-10-15T07:06:25Z-
dc.date.available2013-10-15T07:06:25Z-
dc.date.issued2014en_US
dc.identifier.citationWorld Journal of Surgery, 2014, v. 38 n. 2, p. 385-391en_US
dc.identifier.urihttp://hdl.handle.net/10722/191515-
dc.description.abstractBackground: Routine preoperative laryngeal examination remains controversial. We aimed to assess the utility of preoperative routine flexible laryngoscopy (FL) by looking at the incidence, clinical significance and predictors for preoperative vocal cord paresis (VCP) and incidental laryngopharyngeal conditions (LPC) in our consecutive cohort. Methods: A total of 302 patients underwent laryngeal examination by an independent otorhinolaryngologist and were specifically asked about voice/swallowing symptoms suggestive of VCP 1 day before surgery. As well as vocal cord (VC) mobility, the naso-pharynx and larynx were examined using FL. Any VCP and/or LPC was recorded. VCP was defined as reduced or absent movement in one or more VC. An LPC was considered clinically significant if the ensuing thyroidectomy was changed or deferred. Results: Seven (2.3 %) patients had preoperative VCP, while an additional seven patients had an incidental LPC. Of the seven VCPs, five were caused by previous thyroidectomy, while two were caused by a benign goitre. The incidence of asymptomatic VCP in a previously non-operated cohort was 1/245 (0.41 %). Voice/swallowing symptoms (p = 0.033) and previous thyroidectomy (p < 0.001) were the two significant predictors for VCP. The seven incidental LPCs were vallecular cyst (n = 1), VC scar and polyp (n = 2), nasopharyngeal cyst and polyp (n = 3) and redundant arytenoid mucosa (n = 1); however, as they were benign, all seven patients proceeded to thyroidectomy as planned. Conclusions: Given the low incidence (0.41 %) of asymptomatic VCP in a previously non-operated cohort and that none of the seven LPCs were considered clinically significant, routine preoperative laryngoscopic examination should be reserved for those with previous thyroidectomy and/or voice/swallowing symptoms. © 2013 Société Internationale de Chirurgie.-
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/-
dc.relation.ispartofWorld Journal of Surgeryen_US
dc.rightsThe original publication is available at www.springerlink.com-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleEvaluating the incidence, clinical significance and predictors for vocal cord palsy and incidental laryngopharyngeal conditions before elective thyroidectomy: is there a case for routine laryngoscopic examination?en_US
dc.typeArticleen_US
dc.identifier.emailLang, HHB: blang@hkucc.hku.hken_US
dc.identifier.emailTsang, RKY: rkytsang@hku.hken_US
dc.identifier.authorityLang, HHB=rp01828en_US
dc.identifier.authorityTsang, RKY=rp01386en_US
dc.description.naturepostprint-
dc.identifier.doi10.1007/s00268-013-2259-3-
dc.identifier.pmid24065418-
dc.identifier.scopuseid_2-s2.0-84893165954-
dc.identifier.hkuros226589en_US
dc.identifier.isiWOS:000329638300018-

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