Vocal Fold Immobility After Radiofrequency Ablation of Thyroid Nodules: A Survey of Laryngologists and an Algorithm for Periprocedural Voice Assessment.

Abstract

Rates of vocal fold motion impairment (VFMI) during and after thermal ablative treatments for thyroid nodules have not been well documented. This study surveys a large group of laryngologists to assess the rate of VFMI and dysphonia referral patterns after thermal ablation. A peri-procedural voice assessment algorithm for proceduralists performing thermal ablation for thyroid nodules is presented. Thirteen-question-survey related to VFMI postablation. Sixty-one respondents completed the survey. One-third of total respondents affirmed a VFMI after thermal ablation, with 81% documenting evidence on laryngeal examination. Immediate dysphonia was the most common presenting symptom. Referral patterns varied, but a large portion of patients were referred more than one week postprocedure despite the proceduralist having knowledge of potential VFMI. VFMI is a risk during thermal ablation of thyroid nodules. Greater attention to voice during ablation and use of a procedural voice assessment algorithm may mitigate the risk of injury and potentially improve outcomes.