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Laryngeal complications after thyroidectomy : is it always the surgeon?

Echternach, Matthias and Maurer, Christoph A. and Maurer, Christoph and Mencke, Thomas and Schilling, Martin and Verse, Thomas and Richter, Bernhard. (2009) Laryngeal complications after thyroidectomy : is it always the surgeon? Archives of surgery, Vol. 144. pp. 149-153.

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Official URL: http://edoc.unibas.ch/dok/A6003209

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Abstract

HYPOTHESIS: Laryngeal dysfunction after thyroidectomy is a common complication. However, few data are available to differentiate whether these complications result from injury to the recurrent nerve or to the vocal folds from intubation. SETTING: University medical center. PATIENTS: Seven hundred sixty-one patients who underwent surgery to the thyroid gland from 1990 to 2002. Of these patients, 8.4% underwent a revision thyroidectomy. INTERVENTION: Preoperative and postoperative laryngostroboscopic examination. MAIN OUTCOME MEASURE: Laryngostroboscopic evaluation of laryngeal complications. RESULTS: The overall rate of laryngeal complications was 42.0% (320 patients). Complications from an injury to the vocal folds occurred in 31.3% of patients. Weakness or paresis of the recurrent nerve was initially present in 6.6% and was related to the nerves at risk. This rate was higher in revision thyroidectomies than in primary surgical interventions (6.2% vs 11.6%; P = .04). The rate of laryngeal injuries was higher in patients older than 65 years (39.8% vs 30.8%; P = .03). CONCLUSIONS: These data suggest that laryngeal complications after thyroidectomies are primarily caused by injury to the vocal folds from intubation and to a lesser extent by injury to the laryngeal nerve. We recommend documentation of informed consent, especially for patients who use their voice professionally, such as singers, actors, or teachers.
Faculties and Departments:03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Innere Organe
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Innere Organe
UniBasel Contributors:Maurer, Christoph A.
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:American Medical Association
ISSN:0004-0010
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:24 May 2013 09:22
Deposited On:24 May 2013 09:05

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