Vocal fold mobility alteration reversed after thyroidectomy
Aline Paterno Miazaki, Vergilius José Furtado Araújo-Filho, Lenine Garcia Brandão, Vergilius José Furtado de Araujo-Neto, Leandro Luongo Matos, Claudio Roberto Cerne
Abstract
The involvement of the inferior or recurrent laryngeal nerve (RLN) in mobility derangement of the vocal folds occurs more frequently due to thyroid malignancy invasion. Although uncommon, the same derangement, which is caused by benign thyroid entities, is also described and reverts to normality after a thyroidectomy in up to 89% of cases. In these cases, the pathogenesis of the vocal cord mobility disturbance is attributed to the direct compression of the RLN by massive thyroid enlargement. The authors describe three cases of patients presenting unilateral vocal cord palsy, which, before surgery, was diagnosed by laryngoscopy concomitantly with large and compressive goiter. Vocal fold mobility became normal after the thyroidectomy in all three cases. Therefore, it is noteworthy that these alterations may present reversibility after appropriate surgical treatment. An early surgical approach is recommended to reduce the nerve injury as much as possible; to preserve the integrity of both RLNs since the nerve function will be restored in some patients.
Keywords
References
1. Abboud B, Tabchy B, Jambart S, Hamad WA, Farah P. Benign disease of the thyroid gland and vocal fold paralysis. J Laryngol Otol. 1999;113(5):473-4. http://dx.doi.org/10.1017/S0022215100144251. PMid:10505166.
2. McCall AR, Ott R, Jarosz H, Lawrence AM, Paloyan E. Improvement of vocal cord paresis after thyroidectomy. Am Surg. 1987;53(7):377-9. PMid:3605854.
3. O’Duffy F, Timon C. Vocal fold paralysis in the presence of thyroid disease: management strategies. J Laryngol Otol. 2013;127(8):768-72. http://dx.doi.org/10.1017/S0022215113001552. PMid:23899778.
4. Rowe-Jones JM, Rosswick RP, Leighton SEJ. Benign thyroid disease and vocal cord palsy. Ann R Coll Surg Engl. 1993;75(4):241-4. PMid:8379624.
5. Srirompotong S, Sae-Seow P, Srirompotong S. The cause and evaluation of unilateral vocal cord paralysis. J Med Assoc Thai. 2001;84(6):855-8. PMid:11556465.
6. Mattsson P, Hydman J, Svensson M. Recovery of laryngeal function after intraoperative injury to the recurrent laryngeal nerve. Gland Surg. 2015;4(1):27-35. PMid:25713777.
7. Chhabra A, Ahlawat S, Belzberg A, Andreseik G. Peripheral nerve injury grading simplified on MR neurography: as referenced to Seddon and Sunderland classifications. Indian J Radiol Imaging. 2014;24(3):217-24. http://dx.doi.org/10.4103/0971-3026.137025. PMid:25114384.
8. Holl-Allen RT. Laryngeal nerve paralysis and benign thyroid disease. Arch Otolaryngol. 1967;85(3):335-7. http://dx.doi.org/10.1001/archotol.1967.00760040337018. PMid:6019250.
9. Seddon HJ. A classification of nerve injuries. BMJ. 1942;2(4260):237-9. http://dx.doi.org/10.1136/bmj.2.4260.237. PMid:20784403.
10. Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain. 1951;74(4):491-516. http://dx.doi.org/10.1093/brain/74.4.491. PMid:14895767.
11. Rueger RG. Benign disease of the thyroid gland and vocal cord paralysis. Laryngoscope. 1974;84(6):897-907. http://dx.doi.org/10.1288/00005537-197406000-00002. PMid:4832372.
12. Chang M, Khoo JB, Tan HK. Reversible recurrent laryngeal nerve palsy in acute thyroiditis. Singapore Med J. 2012;53(5):e101-3. PMid:22584984.
13. Jatzko GR, Lisborg PH, Muller MG, Wette VM. Recurrent nerve palsy after thyroid operations: principal nerve identification and a literature review. Surgery. 1994;115(2):139-44. PMid:8310401.
Publication date:
09/29/2016
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email