title: Distinct Disease and Functional Characteristics of Thyroid Surgery-Related Vocal Fold Palsy.
abstract: Iatrogenic trauma induced by thyroid surgery is the most common etiology of unilateral vocal fold paralysis (UVFP). UVFP after thyroid surgery may lead to profound physical and psychosocial distress. This study comprehensively evaluated UVFP caused by thyroid surgery, and compared the results with those caused by other surgical trauma.
  
  
  
  Patients with surgery-related UVFP were evaluated using quantitative laryngeal electromyography, videolaryngostroboscopy, voice acoustic analysis, the Voice Outcome Survey, and the Short Form-36 Health Survey quality-of-life questionnaire. Patients with thyroid surgery and other surgeries were compared.
  
  
  
  A total of 105 patients were recruited, of whom 52 and 53 were assigned to the thyroid surgery and the other surgery group, respectively. Patients in the thyroid surgery group had a higher proportion of external branch of superior laryngeal nerve (eSLN) involvement, longer duration from disease onset to the first laryngeal electromyography examination, lower jitter, higher harmonic-to-noise ratio, and better quality of life compared with the other surgery group. Specifically for patients in the thyroid surgery group, those with eSLN involvement tended to have more pronounced impairment in jitter and shimmer compared with patients without eSLN involvement.
  
  
  
  UVFP caused by thyroid surgery has a distinct clinical presentation with relatively high involvement in the eSLN, better voice acoustics, longer waiting time before asking for evaluation, and less impact on quality of life. The involvement of eSLN in these patients further impaired their voice. Early referral is suggested for these patients, especially with suspected eSLN injury.
authors.affiliation: 1 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou , Taoyuan, Taiwan.
authors.forename: Wen-Chun
authors.initials: WC
authors.lastname: Tseng
authors.affiliation: 1 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou , Taoyuan, Taiwan.|2 School of Medicine, Chang Gung University , Taoyuan, Taiwan.|3 Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou , Taoyuan, Taiwan.|4 Healthy Aging Research Center, Chang Gung University , Taoyuan, Taiwan.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Pei
authors.affiliation: 1 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou , Taoyuan, Taiwan.|4 Healthy Aging Research Center, Chang Gung University , Taoyuan, Taiwan.
authors.forename: Alice M K
authors.initials: AM
authors.lastname: Wong
authors.affiliation: 2 School of Medicine, Chang Gung University , Taoyuan, Taiwan.|5 Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou , Taoyuan, Taiwan.
authors.forename: Hsueh-Yu
authors.initials: HY
authors.lastname: Li
authors.affiliation: 2 School of Medicine, Chang Gung University , Taoyuan, Taiwan.|5 Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou , Taoyuan, Taiwan.
authors.forename: Tuan-Jen
authors.initials: TJ
authors.lastname: Fang
mesh_terms: D000328:Adult; D000368:Aged; D004576:Electromyography; D005260:Female; D006801:Humans; D007821:Laryngeal Muscles / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D011788:Quality of Life; D013061:Speech Acoustics; D049489:Stroboscopy; D013961:Thyroid Gland / Q000601:surgery*; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D014833:Voice Quality