Reiter Rudolf, Heyduck Adrienne, Hoffmann Thomas Karl, Brosch Sibylle, Buchberger Maria Anna, Schorer Katharina, Weber Theresa, Pickhard Anja
Ulm University Medical Center, Universitatsklinikum Ulm, Germany.
Georg-August-Universitat Gottingen, Germany.
Ann Otol Rhinol Laryngol. 2019 Dec;128(12):1104-1110. doi: 10.1177/0003489419858629. Epub 2019 Jul 11.
This study is set to analyze clinicopathological factors predicting the recovery of unilateral vocal fold paralysis (UVP) in patients after thyroid gland surgery. The quality of voice was additionally assessed in these patients.
The charts and videolaryngostroboscopy (VLS) examinations of 84 consecutive patients with a complete UVP after surgery of the thyroid gland were retrospectively reviewed. Patients were divided into 2 groups: patients who fully recovered from vocal fold paralysis and those who failed to recover after a follow-up of 12 months. The quality of voice was analyzed among other things by determining the Voice Handicap Index (VHI).
The UVP fully recovered in 52 of 84 (61.9%) patients. Positive mucosal waves (pMWs) on the paralyzed side, a minimal glottic gap <3 mm seen at the first postoperative VLS, age ≤50 years, and surgery duration ≤120 minutes were associated factors for a complete recovery of nerve function. The voice parameters improved independently from recovery of the paralysis in 90% of the patients.
For patients with a poor prognosis of a UVP, early intervention may be beneficial. Thus, predicting factors for a full recovery of vocal fold motion would be a valuable tool. In our cohort, about 60% of recoveries could have been predicted using the above-mentioned parameters. Good quality of voice was independently reached in 90% of the cases.
本研究旨在分析甲状腺手术后单侧声带麻痹（UVP）患者恢复情况的临床病理因素。此外，还对这些患者的嗓音质量进行了评估。
回顾性分析了84例甲状腺手术后出现完全性UVP患者的病历及视频喉镜频闪检查（VLS）结果。患者分为两组：声带麻痹完全恢复的患者和随访12个月后未恢复的患者。通过确定嗓音障碍指数（VHI）等方法分析嗓音质量。
84例患者中有52例（61.9%）的UVP完全恢复。患侧出现阳性黏膜波（pMWs）、术后首次VLS检查时声门最小间隙<3 mm、年龄≤50岁以及手术时长≤120分钟是神经功能完全恢复的相关因素。90%的患者嗓音参数的改善与麻痹的恢复无关。
对于UVP预后较差的患者，早期干预可能有益。因此，预测声带运动完全恢复的因素将是一个有价值的工具。在我们的队列中，使用上述参数可预测约60%的恢复情况。90%的病例独立达到了良好的嗓音质量。
