Diagnosis of recurrent laryngeal nerve palsy after thyroidectomy: a systematic review

• Published in: International journal of clinical practice (Esher) Vol. 63; no. 4; p. 624
• Main Authors: Jeannon, J-P, Orabi, A A, Bruch, G A, Abdalsalam, H A, Simo, R
• Format: Journal Article
• Language: English
• Published: England 01-04-2009
• Subjects: Humans; Laryngoscopy; Recovery of Function; Sensitivity and Specificity; Stroboscopy; Thyroid Neoplasms - surgery; Thyroidectomy - adverse effects; Thyroidectomy - methods; Vocal Cord Paralysis - diagnosis; Vocal Cord Paralysis - etiology
• ISSN: 1742-1241
• DOI: 10.1111/j.1742-1241.2008.01875.x

Recurrent laryngeal nerve palsy (RLNP) is a recognised possible complication after thyroid surgery. It may present with a variety of symptoms, such as voice change and respiratory symptoms. However, it may remain undetected and the true incidence may be under-reported. The aim of this study was to determine the reported incidence of temporary and permanent palsy after thyroid surgery using different vocal assessment methods.
A Medline search was performed. A systematic review was undertaken which included 27 articles and 25,000 patients.
The average incidence of temporary RLNP after thyroid operations is 9.8% and the incidence of permanent RLNP is 2.3%. The RLNP rate varied according to the method of examining the larynx and ranged from 26% to 2.3%. Most of the reviewed studies recommend a follow-up period up to 1 year to assess and evaluate RLNP.
Our study has identified that different methods are used to diagnose RNLP and that a wide variety of reported RLNP rates exist. We propose establishment of a 'gold standard' for assessing the voice after thyroidectomy to reduce reporting bias.