The impact of recurrent laryngeal neuromonitoring on multi-dimensional voice outcomes following thyroid surgery

Kristin Stevens, Alexander Stojadinovic, Leah B. Helou, Nancy P. Solomon, Robin S. Howard, Craig D. Shriver, Chester C. Buckenmaier, Leonard R. Henry*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Background Voice changes after thyroidectomy are common but not always related to recurrent laryngeal nerve (RLN) injury. We evaluated if RLN neuromonitoring correlated with non-RLN injury-related changes in voice after thyroidectomy. Methods Prospective multi-dimensional voice assessment was conducted on patients undergoing thyroidectomy before, 1-4 weeks, and 6 months postoperatively. Voice outcome (VO) was determined as normal (NormVO) or negative (NegVO) based upon combinations of patient-reported symptoms, videolaryngoscopy, a composite of acoustic measurements, and clinician-perceived voice quality. Groups with and without neuromonitoring were compared for early and durable differences in VO. Results Ninety-one patients underwent thyroidectomy; 39 with RLN neuromonitoring and 52 without. The two study groups were similar with regard to baseline characteristics including voice assessment. There was no difference in NegVO between neuromonitored and non-monitored patients at 1-4 weeks (n=89; 32% vs. 27%; P=0.81) and 6 months (n=71, 14% vs. 7%; P=0.42) after thyroidectomy. Neuromonitoring was associated with a 48-min increase in median operative time, but this finding was not statistically significant in a multivariate model. Conclusion In this study, recurrent laryngeal neuromonitoring did not appear to influence non-RLN injury related VO as measured by a comprehensive multidimensional voice assessment.

Original languageEnglish
Pages (from-to)4-9
Number of pages6
JournalJournal of Surgical Oncology
Issue number1
StatePublished - Jan 2012
Externally publishedYes


  • Neuromonitoring
  • Thyroidectomy
  • Voice


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