title: The cost of vocal fold paralysis after thyroidectomy.
abstract: OBJECTIVE
  To determine the added cost of care and analyze risk factors in patients who suffered vocal fold paralysis (VFP) after thyroid surgery.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Seventy-six patients who developed unilateral or bilateral VFP after thyroidectomy from 2005 through 2009, and a control group of 238 patients who underwent the same surgery without developing VFP, were compared on hospital charges, hospital and intensive care unit (ICU) length of stay (LOS), unplanned intubation, tracheotomies, respiratory failure, readmission, death, pathology, body mass index (BMI), gland weight, swallowing studies, and need for indwelling feeding tube. Differences between outcomes for unilateral VFP patients versus bilateral VFP patients were analyzed. Rate of recovery of VFP and need for further surgery after thyroidectomy were described.
  
  
  RESULTS
  Patients who developed VFP after thyroidectomy had significantly greater rates of all the parameters listed above. BMI, gland weight, and pathology (malignant vs. benign) were not significantly different between the two groups. VFP group underwent additional surgeries after thyroidectomy related to the VFP. Thirty-three% of unilateral VFP patients with long-term follow-up recovered fully. Patients with bilateral VFP with long-term follow-up, had recovery of one vocal fold in 50% and both in 23% of cases.
  
  
  CONCLUSIONS
  Patients with unilateral or bilateral VFP after thyroidectomy experience significantly more morbidity and incurred significantly more health care charges after surgery than similar patients who do not have VFP after thyroidectomy. The likelihood of VFP was not related to malignancy, BMI, or thyroid gland weight in this series.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Henry Ford Health System, Detroit, Michigan 48202, USA. ggardne1@hfhs.org
authors.forename: Glendon Michael
authors.initials: GM
authors.lastname: Gardner
authors.forename: Matthew Michael
authors.initials: MM
authors.lastname: Smith
authors.forename: Kathleen Lynn
authors.initials: KL
authors.lastname: Yaremchuk
authors.forename: Ed Lawrence
authors.initials: EL
authors.lastname: Peterson
mesh_terms: D003422:Critical Care / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics; D057216:Propensity Score; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000009:adverse effects*; D014826:Vocal Cord Paralysis / Q000191:economics* / Q000209:etiology / Q000534:rehabilitation