{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T08:54:29Z","timestamp":1793436869037,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T00:00:00Z","timestamp":1557187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T00:00:00Z","timestamp":1557187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004092","name":"Kuopion Yliopistollinen Sairaala","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004092","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2019,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to determine the incidence, risk factors, and spontaneous recovery rate of vocal fold paresis (VFP) with routine laryngoscopy before and after thyroid surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All consecutive patients undergoing primary or redo thyroid surgery between years 2011\u20132016 were prospectively registered in an electronic database, and scheduled for pre\u2010 and postoperative laryngoscopic vocal fold inspection by otolaryngologists independently of the surgical team.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 920 thyroid operations with 1296\u00a0nerves at risk were performed in 866 patients. Pre\u2010 and postoperative laryngoscopy was done in 95% and 98%, respectively. Preoperative VFP was detected in 24 (2.8%) patients. New postoperative VFP was found in 53 of 920 operations (5.8%) and in 55 of 1296\u00a0nerves at risk (4.2%). After 12\u00a0months, 14 had recovered full vocal fold function and eight had near\u2010complete recovery. VFP was permanent after 29 operations (3.2%); two patients were lost to follow\u2010up with uncertain outcome. Of the 1296\u00a0nerves at risk, injury was permanent in 30 (2.3%). In multivariate analysis, patients operated for recurrent goiter had nearly nine times higher risk of new VFP (23% rate), whereas patients with malignant histology had three times higher risk of postoperative VFP (up to 22% rate).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>VFP continues to be a serious complication of thyroid surgery, especially in operations for redo goiter and thyroid malignancy. The incidence of VFP may be underestimated unless laryngoscopic examinations are performed routinely.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-05021-y","type":"journal-article","created":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T20:50:50Z","timestamp":1557262250000},"page":"2228-2234","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Incidence, Risk Factors, and Natural Outcome of Vocal Fold Paresis in 920 Thyroid Operations with Routine Pre\u2010 and Postoperative Laryngoscopic Evaluation"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6220-9932","authenticated-orcid":false,"given":"Maria","family":"Heikkinen","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Kuopio University Hospital Kuopio Finland"},{"name":"Institute of Clinical Medicine University of Eastern Finland Kuopio 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