Are pre-operative vocal fold checks necessary?

Over a 26-year period, from 1970 to 1995, 2250 pre-operative vocal fold che cks were carried out by the ENT team at Manchester Royal Infirmary in patie nts undergoing thyroid, parathyroid and cardiothoracic surgery. A register was kept of all pre-operative fold checks. This register was retrospectivel y analysed and 23 vocal fold palsies were documented. In six of these patie nts the notes were either missing or incomplete. All of the remaining 17 pa tients had a history suggestive of vocal fold palsy. We suggest that in the absence of symptoms, either current or on history, a routine pre-operative vocal fold check is unnecessary.