What are the guidelines issued by the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNSF) for avoiding complications of thyroid surgery?

Updated: Jan 25, 2018
  • Author: Pramod K Sharma, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

In June 2013, the American Academy of Otolaryngology—Head and Neck Surgery Foundation issued new guidelines designed to highlight the importance of a patient's voice and to improve voice outcomes in patients receiving thyroid surgery. The guidelines include a strong recommendation that surgeons performing thyroid surgery identify the recurrent laryngeal nerve or nerves. [20, 21]

Other recommendations include the following:

  • Assess the patient's voice prior to surgery

  • Examine vocal fold mobility if the patient's voice is impaired

  • Examine vocal fold mobility under defined circumstances if the patient's voice is normal

  • Educate the patient about the possible effect of thyroid surgery on the voice

  • Inform the anesthesiologist of any abnormal preoperative laryngeal assessment

  • Preserve the external branch of the superior laryngeal nerve during surgery

  • Document any voice change after surgery

  • Examine vocal fold mobility in patients with voice change

  • Refer patients with abnormal vocal fold mobility to an otolaryngologist

  • Counsel patients on voice rehabilitation options


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