The impact of surgery type on the recovery of iatrogenic vocal fold injury.

PURPOSE: To study the impact of surgery type causing iatrogenic Vocal Fold Injury (VFI) on recovery and symptoms. METHODS: Retrospective case series of patients with iatrogenic VFI, divided by surgery type: (1) Thyroidectomy; (2) carotid endarterectomy (CEA), and (3) others. The main outcome was vocal fold recovery. Data collected included demographics, medical background, and clinical presentation. Univariate and multivariate logistic regressions were employed to identify recovery predictors. RESULTS: A total of 107 patients were included (69 thyroidectomies, 18 CEA, and 21 other surgeries). Initial recovery was observed in 57 patients (53%), and full recovery in 34 (32%) patients. The median time to initial recovery was 99 days (IQR: 45, 189), while the median time to full recovery was 137.5 days (IQR: 99.75, 294.5). The rates of initial recovery were higher after thyroidectomy compared to CEA (OR = 0.24 (95% CI 0.07–0.7); p < 0.05) and other surgeries (OR = 0.35 95% CI (0.11–0.91); p < 0.05), and of full recovery (OR = 0.21 (95% CI 0.03–0.81; p = 0.05) compared to CEA. Among the examined interventions for VFI, none were associated with initial or complete VFI recovery. Intraoperative RLN identification was associated with initial VFI recovery after thyroidectomy. CONCLUSIONS: Compared with other surgeries, patients with iatrogenic VFI following thyroidectomy are more likely to improve.