Presented in part at the Society of Surgical Oncologists annual cancer symposium. March, 2010, St. Louis Missouri.
Article first published online: 22 AUG 2011
Copyright © 2011 Wiley Periodicals, Inc.
Journal of Surgical Oncology
Volume 105, Issue 1, pages 4–9, 1 January 2012
How to Cite
Stevens, K., Stojadinovic, A., Helou, L. B., Solomon, N. P., Howard, R. S., Shriver, C. D., Buckenmaier, C. C. and Henry, L. R. (2012), The impact of recurrent laryngeal neuromonitoring on multi-dimensional voice outcomes following thyroid surgery. J. Surg. Oncol., 105: 4–9. doi: 10.1002/jso.22063
Author contributions: Conception and design: Stevens, Stojadinovic, Henry; Acquisition of data: Stojadinovic, Helou, Solomon, Shriver, Henry; Analysis and interpretation of data: Stevens, Stojadinovic, Howard, Henry; Drafting of manuscript: Stevens, Henry; Critical revision: Stojadinovic, Helou, Solomon, Howard, Shriver; Statistical expertise: Howard; Supervision: Shriver, Buckenmaier, Henry; Obtaining funding: Buckenmaier.
- Issue published online: 6 DEC 2011
- Article first published online: 22 AUG 2011
- Manuscript Accepted: 20 JUL 2011
- Manuscript Received: 16 JUN 2011
Voice changes after thyroidectomy are common but not always related to recurrent laryngeal nerve (RLN) injury. We evaluated if RLN neuromonitoring correlated with non-RLN injury-related changes in voice after thyroidectomy.
Prospective multi-dimensional voice assessment was conducted on patients undergoing thyroidectomy before, 1–4 weeks, and 6 months postoperatively. Voice outcome (VO) was determined as normal (NormVO) or negative (NegVO) based upon combinations of patient-reported symptoms, videolaryngoscopy, a composite of acoustic measurements, and clinician-perceived voice quality. Groups with and without neuromonitoring were compared for early and durable differences in VO.
Ninety-one patients underwent thyroidectomy; 39 with RLN neuromonitoring and 52 without. The two study groups were similar with regard to baseline characteristics including voice assessment. There was no difference in NegVO between neuromonitored and non-monitored patients at 1–4 weeks (n = 89; 32% vs. 27%; P = 0.81) and 6 months (n = 71, 14% vs. 7%; P = 0.42) after thyroidectomy. Neuromonitoring was associated with a 48-min increase in median operative time, but this finding was not statistically significant in a multivariate model.
In this study, recurrent laryngeal neuromonitoring did not appear to influence non-RLN injury related VO as measured by a comprehensive multidimensional voice assessment. J. Surg. Oncol. 2012; 105:4–9. © 2011 Wiley Periodicals, Inc.