Laryngoscopy in patients undergoing thyroid surgery – is it mandatory or unnecessary routine?


Background: The objective of this study was to evaluate the effectiveness of screening laryngoscopic examination in evaluating vocal fold (VF) mobility before and after thyroid surgery.
Patients and methods: A prospective study of 112 patients underwent thyroid surgery at the Hilla teaching general Hospital and Al-Shafaa private hospital were undertaken in order to study the patterns of pre-operative and postoperative voice changes and Indirect laryngoscope (IDL) findings. Patients with pathologic findings at postoperative laryngoscopy underwent reassessment of voice and (VF) mobility for 6 months duration.
Results: A total of (9.8 %) of patients had pre-operative suspicion of VF Palsy, only (27.3 %) of this group had abnormalities detected on pre-operative IDL .Of 101 documented IDL, no vocal cord pathology in asymptomatic patients were detected.
Post operatively
Conclusions: Preoperative laryngoscopy is necessary in symptomatic patients and those who undergo re operation or in patients when malignancy is suspected. The necessity of a preoperative laryngoscopy in all other patients must be questioned. Postoperative laryngoscopy and additional diagnostic testing better to be reserved for symptomatic patients.