EP7 – High thyroid surgical volume reduces vocal fold immobility compared to intermediate volume

     

    Witt, Robert1
    1 Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA, USA; Biological Sciences, University of Delaware, Newark, DE ,USA; Helen F. Graham Cancer Center, Christiana Care, Newark, DE, USA

     

    Background/Purpose: This study will determine if high thyroid surgical volume compared to intermediate thyroid surgical volume in an individual surgical practice can reduce rates of transient and permanent vocal fold immobility.

    Methods: Single surgeon, single institutional retrospective review comparing vocal fold immobility when a mean of 32 recurrent laryngeal nerves were dissected per year (Group A) versus when 109 recurrent laryngeal nerves were dissected per year (group B). Pre and post-operative fiberoptic laryngoscopy and nerve integrity monitoring were used in both groups.

    Results: The rate of transient and permanent vocal fold immobility in Group A was 3.7% and 1.6%. The rate of transient and permanent vocal fold immobility in Group B was 0% and 0.9%.

    Discussion/Conclusion: High thyroid surgical volume compared to intermediate thyroid surgical volume resulted in a significant improvement in transient vocal fold immobility with a trend toward improvement in permanent vocal fold immobility.

     

    References:

    1. Stavrakis AI, Ituarte PH, Ko CY, Yeh MW. Surgeon volume as a predictor of outcomes in inpatient and outpatient endocrine surgery. Surgery. 2007;142:887–99.
    2. Saunders BD, Wainess RM, Dimick JB, Doherty GM, Upchurch GR, Gauger PG. Who performs endocrine operations in theUnited States? Surgery. 2003;134:924–31.
    3. Sosa JA, Bowman HM, Tielsch JM, Powe NR, Gordon TA.
    4. Udelsman R. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg.1998;228:320–30.
    5. Loyo M, Tufano RP, Gourin CG. National trends in thyroid surgery and the effect of volume on short-term outcomes. Laryngoscope. 2013;123:2056–63.
    6. Gourin CG, Tufano RP, Forastiere AA, Koch WM, Pawlik TP, Bristow RE. Volume-based trends in thyroid surgery. Arch Otolaryngol Head Neck Surg. 2010;136:1191–8.
    7. Kandil E, Noureldine SI, Abbas A, Tufano RP. The impact of surgical volume on patient outcomes following thyroid surgery.
      Witt R. Electrophysiologic Monitoring in Thyroid Surgery: The Standard of Care? J Voice. 2005;19(3):497-500.

 

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