{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:10:38Z","timestamp":1787008238998,"version":"build-2736575974"},"reference-count":28,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T00:00:00Z","timestamp":1572566400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Routine preoperative vocal cord (VC) assessment with laryngoscopy in patients undergoing thyroidectomy allows clear documentation of baseline VC function, aids in surgical planning in patients with palsies, and facilitates interpretation of intraoperative neuromonitoring (IONM) findings. We aimed to determine the incidence of preoperative vocal cord palsy (VCP); to evaluate the associated risk factors for preoperative VCP; and to calculate the cost-savings potential of implementing a selective approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients with a pre-thyroidectomy VC assessment by fiberoptic laryngoscopy were retrospectively recruited from the Monash University Endocrine Surgery Unit database from 2000 to 2018. Cases with preoperative VCP were reviewed for potential contributing factors and compared with a non-palsy cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 5987 patients who had preoperative laryngoscopy, VCP was documented in 41 (0.68%) patients. Four clinical parameters were found to be potential indicators of VCP, including: age (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), nodule \u22653.5\u2009cm recorded on ultrasound imaging (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.01), presence of voice symptoms (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and previous neck surgery (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Malignant cytology (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.5) and exposure to head and neck irradiation were not different between the groups. Utilizing these risk factors, 2354 (39%) patients had at least one feature that may raise suspicion for preoperative VCP. By performing preoperative laryngoscopy only on this subset of patients, the potential cost savings exceeds 400 Australian Dollars per patient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Using this large dataset, we have established that a VCP is rare in the absence of a large nodule, hoarseness, or previous neck surgery. Therefore, in the era of IONM, we support a selective approach to preoperative laryngoscopy by using the aforementioned criteria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2019.0145","type":"journal-article","created":{"date-parts":[[2019,7,23]],"date-time":"2019-07-23T07:15:44Z","timestamp":1563866144000},"page":"1646-1652","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":26,"title":["Routine Preoperative Laryngoscopy for Thyroid Surgery Is Not Necessary Without Risk Factors"],"prefix":"10.1177","volume":"29","author":[{"given":"Dominic I.","family":"Maher","sequence":"first","affiliation":[{"name":"Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Goare","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Forrest","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Grodski","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia."},{"name":"Department of Surgery, Monash University, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan W.","family":"Serpell","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia."},{"name":"Department of Surgery, Monash University, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Australia."},{"name":"Department of Surgery, Monash University, Melbourne, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,11,14]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26119"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1622.1999.01653.x"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12545"},{"key":"e_1_3_4_5_2","first-page":"8","article-title":"Is there a case for selective, rather than routine, preoperative laryngoscopy in thyroid surgery?","volume":"4","author":"Franch-Arcas G","year":"2015","unstructured":"Franch-Arcas G, , Gonzalez-Sanchez C, , Aguilera-Molina YY, , Rozo-Coronel O, , Estevez-Alonso JS, , Munoz-Herrera A. 2015. 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