{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:08:01Z","timestamp":1791486481405,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Recurrent laryngeal nerve (RLN) invasion by thyroid carcinoma represents an advanced disease status with potentially significant co\u2010morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a retrospective single\u2010center study, we included patients with invaded RLNs operated on while using nerve monitoring techniques. We studied pre\u2010, intra\u2010, and postoperative parameters associated with postoperative vocal cord paralysis (VCP); 5\u2010year recurrence\u2010free survival (RFS); and 5\u2010year overall survival (OS) in addition to two subgroup analyses of postoperative VCP in patients without preoperative VCP and based on source of RLN invasion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 65 patients with 66 nerves\u2010at\u2010risk, 39.3% reported preoperative voice complaints. Preoperative VCP was documented in 43.5%. The RLN was invaded by primary tumor in 59.3% and nodal metastasis in 30.5%. Papillary thyroid carcinoma was the most common pathologic subtype (80%). After 6\u2009months, 81.8% had VCP. Complete tumor resection of the RLN was not associated with 5\u2010year RFS (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.24) or 5\u2010year OS (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.9). Resecting the RLN did not offer statistically significant benefit on 5\u2010year RFS (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.5) or 5\u2010year OS (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.38). Radioactive Iodine (RAI) administration was associated with improvement in 5\u2010year RFS (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.006) and 5\u2010year OS (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004). Patients without preoperative VCP had higher IONM amplitude compared with patients with VCP. After a mean follow\u2010up of 65.8\u2009months, 35.9% of patients had distant metastases, whereas 36.4% had recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preoperative VCP accompanies less than half of patients with RLN invasion. Invaded RLNs may have existent electrophysiologic stimulability. Complete tumor resection and RLN resection were not associated with better 5\u2010year RFS or OS, but postoperative RAI was.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 132:2285\u20132292, 2022<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30115","type":"journal-article","created":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T14:06:54Z","timestamp":1648822014000},"page":"2285-2292","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Recurrent Laryngeal Nerve Invasion by Thyroid Cancer: Laryngeal Function and Survival Outcomes"],"prefix":"10.1002","volume":"132","author":[{"given":"Jennifer A.","family":"Brooks","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5611-5833","authenticated-orcid":false,"given":"Amr H.","family":"Abdelhamid Ahmed","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3534-7253","authenticated-orcid":false,"given":"Zaid","family":"Al\u2010Qurayshi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery University of Iowa Hospitals and Clinics  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2765-5413","authenticated-orcid":false,"given":"Dipti","family":"Kamani","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Kyriazidis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery State University of New York Upstate Medical University  Syracuse New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca Jean","family":"Hammon","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Northwest Permanente  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7363-1346","authenticated-orcid":false,"given":"Hongzhi","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Beijing Tongren Hospital, Capital Medical University  Beijing China"},{"name":"Key Laboratory of Otorhinolaryngology\u2010Head and Neck Surgery, Ministry of Education Beijing Institute of Otorhinolaryngology  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niranjan","family":"Sritharan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Westmead &amp; Nepean Hospitals  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Wasserman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily N.","family":"Trinh","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1185-2041","authenticated-orcid":false,"given":"Ayaka J.","family":"Iwata","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Kaiser Permanente Santa Clara Medical Center  California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2462-6775","authenticated-orcid":false,"given":"Yoshiyuki","family":"Saito","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Surgery Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1459-399X","authenticated-orcid":false,"given":"Selen","family":"Soylu","sequence":"additional","affiliation":[{"name":"Department of General Surgery Basaksehir Cam and Sakura City Hospital.  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5373-9181","authenticated-orcid":false,"given":"Gregory W.","family":"Randolph","sequence":"additional","affiliation":[{"name":"Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology\u2010Head and Neck Surgery Massachusetts Eye and Ear Infirmary, Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Surgery Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"R Score Research Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880160211"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27360"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199707000-00012"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10058"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813504735"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23619"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2147\/OTT.S142799"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2006.02.006"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2008.04.017"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-012-1518-z"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/616521"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817697189"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26393"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27359"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21119"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0064"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej11-0355"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0960-7404(03)00032-x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-014-2906-3"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1089\/105072502320908321"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24928"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.08.009"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000191472.02720.1f"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001688"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31812eecc4"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30115","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.30115","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30115","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T04:13:20Z","timestamp":1692677600000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.30115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1002\/lary.30115"],"URL":"https:\/\/doi.org\/10.1002\/lary.30115","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]},"assertion":[{"value":"2021-12-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}