title: Are diabetic patients at a greater risk to develop a vocal fold palsy during thyroid surgery than nondiabetic patients?
abstract: BACKGROUND
  Diabetic neuropathy is reported to be an independent risk factor for the development of a vocal fold palsy (VFP), and nerves in diabetic patients are suspected to have an increased vulnerability to mechanical trauma. This retrospective study was performed to find out whether diabetic patients were at a greater risk to acquire VFP than were nondiabetic patients in a large cohort who underwent thyroid surgery.
  
  
  METHODS
  Records of patients who underwent initial thyroid surgery at our institution between 1995 and 1999 were reevaluated. Results of preoperative and postoperative laryngoscopy, repeated laryngoscopy 6 months after operation, and concomitance of diabetes were registered.
  
  
  RESULTS
  Six hundred thirty patients were retrospectively analyzed. Preoperative laryngoscopy revealed a unilateral VFP in 3 of 44 diabetic patients (6.8%) and in 4 of 586 (0.7%) nondiabetic patients. Five of 44 diabetic patients (11.4%) and 49 of 586 nondiabetic patients (8.4%) acquired VFP perioperatively, which was permanent in 2 diabetic patients (4.5%) and 8 nondiabetic patients (1.4%). The incidence of preoperative VFP in the diabetic patients was significantly greater than in nondiabetic patients (P = .0091). The incidence of postoperative and permanent VFP did not differ significantly.
  
  
  CONCLUSIONS
  Thyroid surgery can be performed safely in diabetic patients, as they are not at a greater risk to acquire VFP than nondiabetic patients.
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, Philipps-University, Marburg, Germany. pluntke@med.uni-marburg.de
authors.forename: Katja
authors.initials: K
authors.lastname: Schlosser
authors.forename: Katja
authors.initials: K
authors.lastname: Maschuw
authors.forename: Iyad
authors.initials: I
authors.lastname: Hassan
authors.forename: Elias
authors.initials: E
authors.lastname: Karakas
authors.forename: Hoffmann
authors.initials: H
authors.lastname: Sebastian
authors.forename: Emily P
authors.initials: EP
authors.lastname: Slater
authors.forename: Matthias
authors.initials: M
authors.lastname: Rothmund
authors.forename: Emilio Domínguez
authors.initials: ED
authors.lastname: Fernández
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000453:epidemiology / Q000601:surgery*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000453:epidemiology*; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012009:Recurrent Laryngeal Nerve / Q000601:surgery; D061226:Recurrent Laryngeal Nerve Injuries; D012189:Retrospective Studies; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000601:surgery*; D014826:Vocal Cord Paralysis / Q000453:epidemiology*