Abstract:Objective To investigate the cause and treatment of delayedonsef hoarseness after thyroidecomy.
Methods The clinical data of 3180 cases of thyroid disease treated by surgery in our department between 1995~2005 and the 102 cases(3.2%) who developed postoperative delayedonset hoarseness were analyzed respectively.
Results The complication rate of postoperative delayedonset hoarseness for thyroid carcinoma was 5.1%, which was obviously higher than that of benign thyroid disease (2.9%)(P<0.05). The rate in patients in whom the inferior thyroid arteries were ligated intracapsularly and the posterior thyroid capsule was retained (2.3%) was significantly lower than that in patients with extracapsular ligation of the arteries and the posterior capsule was not retained (4.8%, P<0.05). The complication rate in reoperative patients (6.5%) was markedly higher than that in patients who underwent primary operation (3.0 %)(P<0.05). However, there was no difference between the cases in which the recurrent laryngeal nerves were exposed and those in which the nevers were not exposed(P>0.05). In all of the patients with delayedonset hoarseness, ultrasonographic exammation showed various degrees of fluid accumulation in the operative field. Seventyfive of 77 cases(97.4%) with this complication were cured with combined theropy, which was significantly higher than the recovery rate of those cases without treatment(84.0%)(P<0.05).
Conclusions Adequate drainage plays an important role in preventing delayedonset hoarseness. Applying aggressive combined therapy is the key point to cure this complication.