Abstracto

Flexible Fibreoptic Laryngoscopy versus Simple Voice Assessment in a Routine Clinical Setting to Predict Vocal Cord Paralysis after Thyroid Surgery

Sah BP , Bhandary S, Joshi RR , Chettri ST, Natesh V

Backgrounds: Thyroid disease has a high prevalence in the general population, with a female predominance. Thyroidectomy is a very frequently performed surgical procedure for the treatment of benign and malignant nodules. The intricate and delicate anatomical structures for voice production lie in proximity to the thyroid gland and are vulnerable during operations on the thyroid.

Aims and objectives: To find predictive value of vocal cord palsy as observed by simple voice assessment following thyroid surgery using flexible fibreoptic laryngoscopy as gold standard.

Materials and Method: This was a prospective observational study. 42 diagnosed cases of thyroid swelling that were undergone different modalities of thyroidectomy from February 2009 to January 2010 were enrolled in study. Age, sex, geographical distribution, vocal cord status and post operative voice changes at 5th and 30th days were recorded and analyzed. Results: Age range was 15 to 63 yrs. Female to male ratio was 5:1. Sensitivity, specificity, positive predictive value, negative predictive value of subjective and objective voice change to predict vocal cord palsy at 5th postoperative day were 70% and 80%, 75% and 81.3%, 46.67% and 57.14%, 88.89% and 92.85% respectively, at 30th postoperative day were 71.42% and 85.71%, 88. 57% and 85.71%, 55% and 54.54%, 93.93% and 96.77% respectively. Conclusions: Prediction of postoperative vocal cord palsy could not be done with simple voice assessment.