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Strategies to prevent bilateral vocal fold paralysis in thyroid surgery

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Journal of Neuromonitoring & Neurophysiology Vol.4 No.1.jpg

Thyroid surgery carries the risk of bilateral vocal fold paralysis (VFP), which can lead to airway compromise and necessitate intervention. Despite surgical advancements, 45% of patients experience permanent paralysis, with a 30% risk of tracheotomy. Bilateral VFP can compromise the airway, presenting with noisy breathing and voice changes. Hemi-thyroidectomy carries a lower VFP risk than total thyroidectomy. IONM aids RLN preservation but hasn't consistently lowered VFP rates. Continuous IONM benefits RLN preservation but its effect on VFP rates is debated. Staged surgery post-ipsilateral nerve injury may reduce bilateral VFP risk. Preventing bilateral VFP in thyroid surgery is of paramount importance. Utilizing routine IONM and implementing staged surgery following ipsilateral nerve injury could potentially reduce the incidence of bilateral VFP. However, additional research is warranted to establish the most effective management strategies for optimizing patient outcomes in thyroid surgery.

Introduction

Main Text

Does the Use of Intraoperative Nerve Monitoring (IONM) Help to Reduce the Occurrence of Bilateral VFP?

Does Continuous Vagal IONM Help to Reduce the Occurrence Rate of Bilateral VFP?

Does Staged Surgery Help to Prevent Bilateral VFP after Ipsilateral Thyroidectomy?

Tips for Preventing Bilateral VFP

Conclusion

Acknowledgments

Funding

Conflict of Interest

ORCID

References

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