{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T14:25:54Z","timestamp":1781533554753,"version":"3.54.5"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T00:00:00Z","timestamp":1538524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001868","name":"National Science Council","doi-asserted-by":"publisher","award":["MOST 105\u20102314\u2010B\u2010182A\u2010070\u2010MY2"],"award-info":[{"award-number":["MOST 105\u20102314\u2010B\u2010182A\u2010070\u2010MY2"]}],"id":[{"id":"10.13039\/501100001868","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG 3D1413"],"award-info":[{"award-number":["CMRPG 3D1413"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["5D0161\u20104"],"award-info":[{"award-number":["5D0161\u20104"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>We aimed to identify the risk factors for iatrogenic unilateral vocal fold paralysis (UVFP) caused by thyroid surgery, to allow the identification of patients requiring nerve\u2010protection procedures and monitoring technologies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case study in a medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent thyroid surgery from April 2011 to February 2016 and who were diagnosed with UVFP by laryngoscopy and laryngeal electromyography were included. Patient demographics, types of surgery, and characteristics of the thyroid lesions were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty (2.1%) of 2,815 patients who received thyroid surgery developed UVFP. The risk of UVFP was higher in patients over 60 years old (odds ratio, 1.89; 95% confidence interval, 1.01\u20103.26; <jats:italic>P<\/jats:italic>\u2009=\u2009.01). Involvement of the external branch of superior laryngeal nerve (EBSLN) occurred in 19 (31.7%) of the 60 UVFP patients, and was more likely to occurr in patients with diabetes mellitus (odds ratio, 14.19; 95% confidence interval, 3.80\u201052.94; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). The incidence of UVFP and involvement of the EBSLN differed among surgery types, and was the highest among patients undergoing total thyroidectomy with neck dissection (TTND) (10\/158, 6.3% and 5\/158, 3.2%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The risk of thyroid surgery\u2013related UVFP is higher in older patients. EBSLN involvement is more likely in patients with diabetes mellitus. TTND is associated with higher risks of UVFP and EBSLN injury than other types of surgery, implying the need of intraoperative nerve monitoring in these high\u2010risk characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 129:275\u2013283, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27336","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T19:25:39Z","timestamp":1538767539000},"page":"275-283","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Risk factors for thyroid surgery\u2013related unilateral vocal fold paralysis"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1272-8133","authenticated-orcid":false,"given":"Hung\u2010Chun","family":"Chen","sequence":"first","affiliation":[{"name":"From the Department of Otolaryngology\u2013Head and Neck Surgery  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Cheng","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation  Taoyuan Taiwan"},{"name":"Center of Vascularized Tissue Allograft Chang Gung Memorial Hospital at Linkou  Taoyuan Taiwan"},{"name":"the Healthy Aging Research Center"},{"name":"the School of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuan\u2010Jen","family":"Fang","sequence":"additional","affiliation":[{"name":"From the Department of Otolaryngology\u2013Head and Neck Surgery  Taoyuan Taiwan"},{"name":"the School of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,3]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"79","article-title":"Unilateral recurrent laryngeal nerve 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