Management of Vocal Cord Palsy during Thyroid Surgery

Korean Journal of Head & Neck Oncology 1998;14(1):27-34.
Published online May 30, 1998.

Hong Shik Choi;Se Heon Kim;Kuk Jin Park;Kwang Moon Kim;Won Pyo Hong

갑상선 수술 시의 성대마비의 처치

최홍식;김세헌;박국진;김광문;홍원표

Abstract

Objectives, Materials & Methods: To prevent deterioration of postoperative voice due to iatrogenic transection of the recurrent laryngeal nerve during the thyroid surgery, intraoperative medialization of the membranous vocal cord by type I thyroplasty together with direct epineurial neurorraphy was done on 2 cases of benign thyroid lesion. To improve the quality of voice together with complete removal of advanced thyroid carcinoma, intraoperative vocal cord medialization on the lesion side together with total thyroidectomy was done by type I thyroplasty in 2 cases and combined procedure by arytenoid adduction and type I thyroplasty in another 2 cases.
Results
The resultant voice of the iatrogenic injury cases was relatively tolerable. The voice of the combined procedure was better than that of type I thyroplasty cases for the intraoperative rehabilitation cases. Not only for the preoperative evaluation of the severity of the nerve lesion but also the prognosis will be expected by use of laryngeal EMG in the cases of thyroid cacer with vocal cord palsy.
Conclusion
Intraoperative simultaneous rehabilitation for the vocal cord palsy during thyroid surgery is beneficial for the patients.

Key Words: Vocal cord palsy, Thyroid cancer, Type I thyroplasty, Arytenoid adduction, Laryngeal EMG