[Specific features of laryngeal paresis following surgical treatment of diffuse toxic goiter (a prospective longitudinal passive study)]

Abstract

Specific manifestations of postoperative laryngeal paresis observed with the use of indirect laryngoscopy are described in 53 patients subjected to the surgical treatment of diffuse toxic goiter. Laryngeal paresis was shown to develop both in the early (up to 7 days) and in the late (over 14 days) postoperative periods. The delayed form of pathology accounted for 13% of the total number of the cases of postoperative laryngeal paresis. The standard treatment of transient postoperative laryngeal paresis resulted in the complete recovery of vocal cord mobility within 1-6 months after the onset of therapy, regardless of the state of the cords at the time of diagnosis of the disease. Persistent postoperative laryngeal paresis developed by the end of the 15 month observation period. Phonation was found to be preserved in 66% of the patients in whom laryngeal paresis (unilateral abduction paresis) had been diagnosed by indirect laryngoscopy. In all the remaining patients, phonation recovered 15 months or more after surgery. The authors argue that neither the recovery nor the preservation of phonation can be a criterion for the absence of complications. Also, the outcome of surgical intervention unsupported by the results of laryngoscopy performed within 1, 6, and 15 months after the treatment does not reflect the true structure of postoperative complications.