Phonation disorders after
thyroidectomy are among the most common complications and occur as a result of recurrent laryngeal nerve (RLN) injury. The multivariate analysis of risk factors for
phonation disorders after
thyroidectomy was assessed. A group of 830 patients with 1500 RLNs at risk of injury during
thyroidectomy were analyzed retrospectively. The impact of the method of RLN identification, age, sex, BMI, kind of thyroid surgery, pathology, surgeon's experience and thyroid volume on
vocal cord paralysis was analyzed. We found that the retrosternal
goiter and the volume above 100 mL were the most important risk factors for both transient and permanent
paralysis.
Thyroid cancer had a statistically significant impact on the increase in permanent
paralysis, while this indication had practically no impact on transient
paralysis. Among patients over 65 years with
obesity, the probability of transient complications approximately doubled, with no effect on the permanent
paralysis. Men were approximately 1.7 times more likely to develop any type of
phonation disorder. Secondary operations more than doubled the risk of transient and permanent
vocal cord paralysis.
Thyroidectomy with only visual RLN identification was associated with a risk of both transient and permanent
vocal cord paralysis almost two times higher, compared to neuromonitoring.