title: Preoperative vocal cord paralysis and its association with malignant thyroid disease and other pathological features.
abstract: BACKGROUND
  Vocal cord paralysis (VCP) is found in both benign and malignant thyroid disease. This study was performed to determine if the presence of preoperative VCP predicts malignancy.
  
  
  METHODS
  A retrospective analysis was performed on a cohort of 1923 consecutive patients undergoing thyroid surgery. The incidence of preoperative VCP was recorded. Patient and nodule characteristics were correlated with final pathology.
  
  
  RESULTS
  1.3% of our cohort was found to have preoperative VCP. Malignant pathology was discovered in 76% of patients with preoperative VCP. Among these patients, 72% had a left sided paralysis. 10.5% of patients with preoperative VCP had perineural invasion (PNI) on final pathology, compared to 1.1% of patients with normal VC function.
  
  
  CONCLUSIONS
  Preoperative VCP appears to be a strong, though not an absolute, indicator of malignancy. Most VCP were on the left side. Assessing for preoperative VCP is crucial in all patients who need thyroid surgery, as even benign nodules can be accompanied by preoperative vocal cord paralysis.
authors.affiliation: Department of Otolaryngology - Head and Neck surgery, McGill University, Montreal, QC, Canada.
authors.forename: Emily
authors.initials: E
authors.lastname: Kay-Rivest
authors.affiliation: Department of General surgery, McGill University, Montreal, QC, Canada.
authors.forename: Elliot
authors.initials: E
authors.lastname: Mitmaker
authors.affiliation: Division of Head and Neck Surgery, Department of Otolaryngology - Head and Neck surgery, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Payne
authors.affiliation: Division of Head and Neck Surgery, Department of Otolaryngology - Head and Neck surgery, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hier
authors.affiliation: Division of Head and Neck Surgery, Department of Otolaryngology - Head and Neck surgery, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
authors.forename: Alex M
authors.initials: AM
authors.lastname: Mlynarek
authors.affiliation: Division of Head and Neck Surgery, Department of Otolaryngology - Head and Neck surgery, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Young
authors.affiliation: Division of Head and Neck Surgery, Department of Otolaryngology - Head and Neck surgery, Jewish General Hospital, McGill University, Montreal, QC, H3T 1E2, Canada. viforest@yahoo.ca.
authors.forename: Véronique-Isabelle
authors.initials: VI
authors.lastname: Forest
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery; D013961:Thyroid Gland / Q000473:pathology* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014827:Vocal Cords / Q000503:physiopathology; D014833:Voice Quality / Q000502:physiology*