Pre- and Post-Thyroidectomy Voice Assessment

  • Salem I. Noureldine
  • Ralph P. TufanoEmail author


After thyroid surgery, a change in voice from baseline is considered to be the most common complication. The presence or absence of recurrent laryngeal nerve (RLN) dysfunction does not solely predict functional voice outcome after thyroidectomy, as other mechanisms can affect vocal fold function. Nonetheless, when reading the pertinent literature, it becomes obvious that the true incidence of temporary and permanent vocal fold paralysis (VFP) after thyroid surgery is still unknown. The majority of previous studies that have examined the incidence of VFP have lacked adequate assessment of postoperative vocal fold function. The reason for this variance in practice is due to the lack of consensus from the surgical professional societies and the difference in the professional background and training of today’s thyroid surgeons. Such statistics about the true risk of RLN injury with subsequent temporary or permanent VFP rates are important in obtaining informed patient consent before proceeding with thyroidectomy. Pre- and postoperative assessment of vocal fold function for patients undergoing thyroid surgery may help to detect an existing preoperative RLN palsy or an early iatrogenic RLN injury. Knowing this information may help to develop an appropriate surgical plan preoperatively and intervene supportively in a patient who may have vocal fold motion impairment postoperatively. Herein, we discuss the technical considerations for voice assessment during thyroid surgery and the rationale for routine pre- and postoperative laryngeal assessment of the larynx.


Vocal fold paralysis Recurrent laryngeal nerve Voice assessment Fiberoptic laryngoscopy Thyroidectomy Laryngeal exam 


Conflicts of Interest Disclosures

All authors report no conflicts of interest.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Division of Head and Neck Endocrine Surgery, Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreUSA

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