Articles
| Open Access | UNILATERAL VOCAL CORD PARALYSIS AFTER THYROIDECTOMY: CURRENT CONCEPTS IN PATHOGENESIS, DIAGNOSIS, AND REHABILITATION
Khaydarova Gavhar Saidahmatovna, Karimova Muborakkhon Dilmurod kizi , Department of Otorhinolaryngology, Tashkent State Medical University, Tashkent, UzbekistanAbstract
Background:
Unilateral vocal cord paralysis (UVCP) remains one of the most significant complications after thyroidectomy, often resulting in hoarseness, aspiration, and reduced quality of life. Despite advances in surgical techniques, the risk of recurrent laryngeal nerve injury persists.
Objective:
This review summarizes recent evidence (2018–2025) on the incidence, mechanisms, diagnostic approaches, and rehabilitation strategies for UVCP following thyroid surgery.
Methods:
A narrative review of peer-reviewed literature indexed in PubMed, Scopus, and Web of Science was conducted using the keywords unilateral vocal cord paralysis, thyroidectomy, recurrent laryngeal nerve, neuromonitoring, and voice rehabilitation.
Results:
The incidence of UVCP varies between 1% and 2% in primary thyroid surgeries and up to 8% in reoperations. The predominant cause is injury to the recurrent laryngeal nerve through traction, thermal damage, or ischemia. Modern diagnostic methods, including laryngeal electromyography and high-resolution ultrasound, enable early recognition. Intraoperative neural monitoring (IONM) significantly reduces permanent nerve injury rates. Rehabilitation options, such as voice therapy and injection laryngoplasty, improve phonatory outcomes and patient satisfaction.
Conclusion:
Early diagnosis, standardized intraoperative nerve monitoring, and structured voice rehabilitation are key to improving outcomes. Future research should focus on neuroregenerative therapies and advanced intraoperative visualization systems.
Keywords
unilateral vocal cord paralysis, thyroidectomy, recurrent laryngeal nerve, intraoperative neuromonitoring, laryngeal electromyography, voice rehabilitation
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