Immediate and partial neural dysfunction after thyroid and parathyroid surgery: Need for recognition, laryngeal exam, and early treatment
Corresponding Author
Vaninder K. Dhillon MD
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University National Capital Region, Bethesda, Maryland, USA
Correspondence
Vaninder K. Dhillon, MD, 6420 Rockledge Drive Suite 4920; Bethesda, Maryland 20817.
Email: [email protected]
Search for more papers by this authorGregory W. Randolph MD
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorBrendan C. Stack Jr MD
Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA
Search for more papers by this authorBrenessa Lindeman MD
Department of General Surgery, Surgical Oncology, University of Alabama, Birmingham, Alabama, USA
Search for more papers by this authorGary Bloom
ThyCa: Thyroid Cancer Survivors' Association, Inc., Olney, Maryland, USA
Search for more papers by this authorCatherine F. Sinclair MBBS, BSc, MD
Department of Otolaryngology-Head and Neck Surgery, Mount Sinai West Hospital, New York, New York, USA
Search for more papers by this authorGayle Woodson MD
Department of Otolaryngology-Head and Neck Surgery, Drexel University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorJennifer A. Brooks MD, MPH
Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorLesley F. Childs MD
Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
Search for more papers by this authorNazanene H. Esfandiari MD
Department of Internal Medicine, Metabolism, Endocrinology & Diabetes (MEND), University of Michigan, Ann Arbor, Michigan, USA
Search for more papers by this authorLisa Evangelista CscD, CCC-SLP
Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, California, USA
Search for more papers by this authorElizabeth Guardiani MD
Department of Otolaryngology-Head and Neck Surgery, University of Maryland, Baltimore, Maryland, USA
Search for more papers by this authorLourdes Quintanilla-Dieck MD
Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Oregon, Portland, USA
Search for more papers by this authorMatthew R. Naunheim MD, MBA
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorMaisie Shindo MD
Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Oregon, Portland, USA
Search for more papers by this authorMichael Singer MD
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA
Search for more papers by this authorNeil Tolley MB, BCh, MD
Department of Otolaryngology-Head and Neck Surgery, Imperial College NHS Trust, London, UK
Search for more papers by this authorPeter Angelos MD, PhD
Department of Surgery, University of Chicago School of Medicine, Chicago, Illinois, USA
Search for more papers by this authorRobbi Kupfer MD
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
Search for more papers by this authorVictoria Banuchi MD
Department of Otolaryngology-Head and Neck Surgery, Weill Cornell School of Medicine, New York, New York, USA
Search for more papers by this authorWhitney Liddy MD
Department of Otolaryngology-Head and Neck Surgery, Northwestern University, Chicago, Illinois, USA
Search for more papers by this authorRalph P. Tufano MD, MBA
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
Search for more papers by this authorCorresponding Author
Vaninder K. Dhillon MD
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University National Capital Region, Bethesda, Maryland, USA
Correspondence
Vaninder K. Dhillon, MD, 6420 Rockledge Drive Suite 4920; Bethesda, Maryland 20817.
Email: [email protected]
Search for more papers by this authorGregory W. Randolph MD
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorBrendan C. Stack Jr MD
Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA
Search for more papers by this authorBrenessa Lindeman MD
Department of General Surgery, Surgical Oncology, University of Alabama, Birmingham, Alabama, USA
Search for more papers by this authorGary Bloom
ThyCa: Thyroid Cancer Survivors' Association, Inc., Olney, Maryland, USA
Search for more papers by this authorCatherine F. Sinclair MBBS, BSc, MD
Department of Otolaryngology-Head and Neck Surgery, Mount Sinai West Hospital, New York, New York, USA
Search for more papers by this authorGayle Woodson MD
Department of Otolaryngology-Head and Neck Surgery, Drexel University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorJennifer A. Brooks MD, MPH
Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorLesley F. Childs MD
Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
Search for more papers by this authorNazanene H. Esfandiari MD
Department of Internal Medicine, Metabolism, Endocrinology & Diabetes (MEND), University of Michigan, Ann Arbor, Michigan, USA
Search for more papers by this authorLisa Evangelista CscD, CCC-SLP
Department of Otolaryngology-Head and Neck Surgery, University of California, Davis Medical Center, California, USA
Search for more papers by this authorElizabeth Guardiani MD
Department of Otolaryngology-Head and Neck Surgery, University of Maryland, Baltimore, Maryland, USA
Search for more papers by this authorLourdes Quintanilla-Dieck MD
Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Oregon, Portland, USA
Search for more papers by this authorMatthew R. Naunheim MD, MBA
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
Search for more papers by this authorMaisie Shindo MD
Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Oregon, Portland, USA
Search for more papers by this authorMichael Singer MD
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA
Search for more papers by this authorNeil Tolley MB, BCh, MD
Department of Otolaryngology-Head and Neck Surgery, Imperial College NHS Trust, London, UK
Search for more papers by this authorPeter Angelos MD, PhD
Department of Surgery, University of Chicago School of Medicine, Chicago, Illinois, USA
Search for more papers by this authorRobbi Kupfer MD
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
Search for more papers by this authorVictoria Banuchi MD
Department of Otolaryngology-Head and Neck Surgery, Weill Cornell School of Medicine, New York, New York, USA
Search for more papers by this authorWhitney Liddy MD
Department of Otolaryngology-Head and Neck Surgery, Northwestern University, Chicago, Illinois, USA
Search for more papers by this authorRalph P. Tufano MD, MBA
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
Search for more papers by this authorAbstract
Background
Laryngeal dysfunction after thyroid and parathyroid surgery requires early recognition and a standardized approach for patients that present with voice, swallowing, and breathing issues. The Endocrine Committee of the American Head and Neck Society (AHNS) convened a panel to define the terms “immediate vocal fold paralysis” and “partial neural dysfunction” and to provide clinical consensus statements based on review of the literature, integrated with expert opinion of the group.
Methods
A multidisciplinary expert panel constructed the manuscript and recommendations for laryngeal dysfunction after thyroid and parathyroid surgery. A meta-analysis was performed using the literature and published guidelines. Consensus was achieved using polling and a modified Delphi approach.
Results
Twenty-two panelists achieved consensus on five statements regarding the role of early identification and standardization of evaluation for patients with “immediate vocal fold paralysis” and “partial neural dysfunction” after thyroid and parathyroid surgery.
Conclusion
After endorsement by the AHNS Endocrine Section and Quality of Care Committee, it received final approval from the AHNS Council.
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