Evaluation of vocal cord function after thyroid surgery

Objective: To compare clinical evaluation and indirect laryngoscopy with videolaryngostroboscopy (VLS), which is a new method of diagnosing abnormalities and dysfunction of the vocal folds. Design: Prospective study. Setting: Teaching hospital, Turkey. Subjects: 218 patients who required thyroidectomy and who had no vocal abnormality preoperatively. Interventions: Clinical evaluation, indirect laryngoscopy, and VLS before operation and on the second postoperative day. Main outcome measures: Sensitivity and specificity. Results: The specificity of all three investigations was 100%. The sensitivity of VLS was 100%, of clinical evaluation 81%, and of indirect laryngoscopy 67%. Conclusions: Clinical evaluation and indirect laryngoscopy are safe ways of evaluating abnormalities of the vocal cords postoperatively. It would probably not be cost-effective to use VLS routinely, but for differential diagnosis and evaluation of prognosis of vocal abnormalities after thyroidectomy it is more accurate.