Can Vocal Cord Damage from Thyroid Surgery Be Reversed?

Vocal cords

Hello Doctor: If a patient undergoes surgery on the thyroid and the recurrent laryngeal nerve is affected, and the vocal cords do not recover on their own after six months, will they never recover permanently? Is it necessary to undergo another surgery to correct the vocal cords? Thank you.

Xiao Ya, 20~29 year old female. Ask Date: 2003/08/25

Dr. Chen Junliang reply Otolaryngology

If the recurrent laryngeal nerve is injured during thyroid surgery, and after six months of observation and treatment there is still no recovery, the chances of recovery are quite low.
Surgical intervention by a neurosurgeon may only be considered in cases of severe injury, and even then, the outcomes may not be very promising.

Reply Date: 2003/08/25

More Info

Vocal cord damage resulting from thyroid surgery, particularly when the recurrent laryngeal nerve (RLN) is affected, is a significant concern. The RLN is responsible for innervating the muscles that control the vocal cords. Damage to this nerve can lead to vocal cord paralysis, which may manifest as hoarseness, breathiness, or even loss of voice.
In terms of recovery, the prognosis for vocal cord function after nerve injury can vary widely. If the nerve is temporarily affected during surgery, there is a chance that function may return over time. Studies indicate that many patients experience spontaneous recovery within six months to a year post-surgery, particularly if the nerve was only bruised or stretched rather than completely severed. However, if there is no improvement after six months, the likelihood of spontaneous recovery diminishes significantly.

In cases where vocal cord paralysis persists, surgical intervention may be necessary to restore voice function. There are several surgical options available, including:
1. Medialization Laryngoplasty: This procedure involves placing an implant to push the paralyzed vocal cord closer to the midline, improving voice quality.
2. Reinnervation Procedures: In some cases, surgeons may attempt to reconnect the nerve or use other nerves to stimulate the vocal cords.

3. Voice Therapy: While not a surgical option, working with a speech-language pathologist can help optimize vocal function and may be beneficial in conjunction with surgical interventions.

It's crucial to have a thorough evaluation by an otolaryngologist (ENT specialist) who can assess the extent of the nerve damage and recommend the most appropriate treatment options based on individual circumstances. They may also conduct laryngeal examinations, such as laryngoscopy, to visualize the vocal cords and determine the best course of action.

In summary, while some vocal cord damage may recover on its own, persistent issues after six months often require surgical intervention to improve vocal function. Early assessment and intervention are key to achieving the best outcomes. If you are experiencing vocal changes after thyroid surgery, it is advisable to consult with a specialist who can provide personalized guidance and treatment options.

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