BENIGN THYROID-DISEASE AND VOCAL CORD PALSY

The case notes of 2453 consecutive patients admitted for thyroid surge ry and with successful preoperative laryngoscopy were examined retrosp ectively. Of the 2408 patients who had not had previous operations on the gland, 2321 proved to have benign pathology. A total of 29 patient s had a preoperative vocal cord palsy of which 22 were associated with benign disease. Return of cord movement after surgery occurred in 89% of the patients with a benign goitre. We advocate routine preoperativ e laryngoscopy to detect vocal cord paresis. Such a finding with a goi tre does not necessarily indicate malignancy. The recurrent laryngeal nerve should therefore be identified at surgery and preserved to allow for recovery of vocat cord movement.