Potential of Comprehensive Medical Treatment of Complex Laryngeal Nerve Injuries in Thyroid Surgery

Main Article Content

V.V. Voitenko
V.O. Palamarchuk


Aim of the study. The key point of this research is studying the impact of different methods of medical treatment for patients with dysphonic syndrome after thyroid surgery due to intraoperative injury of the upper laryngeal nerve and complex injury of superior laryngeal nerve as well as the recurrent laryngeal nerve. Materials and methods. The research of various methods of medical treatment was performed on 47 patients after thyroid surgery with dysphonic manifestations. The patients were euthyroid; they were examined at all stages of the treatment by ENT specialist using video laryngoscope. The indices of acoustic voice analysis and evaluation of the voice handicap index, VHI‑30, were determined. The proposed method involves the application of a combination of two pharmacological agents: lysine and choline alfoscerate. At an early postoperative period in case of identifying dysphonic disorders the appropriate medical therapy was prescribed to patients. Identification of the indices of acoustic voice analysis, evaluation of the voice handicap index and fiber laryngoscopy aspect were carried out in groups of patients on the seventh and fourteenth day after the treatment order. Results. All the patients were divided into four groups. Conventional therapy was applied for the patients with diagnosed dysphonic syndrome in the first and the third groups. Patients in the second and the fourth groups received a combined therapy with lysine and cholini alfosceras. The study revealed that in the 2nd and the 4th groups of patients there was a significant change of indices with the trend to almost normal values in comparison with the 1st and the 3rd groups due to increased F0 and ΔF0. It is of great importance that the quality of life has improved, as evidenced by the decrease of VHI‑30. Conclusions. Using a combination of lysine and cholini alfosceras in postoperative dysphonia treatment indicates the effectiveness of this technique as compared to conventional drug therapy due to the improvement of mental and emotional states and functionality of the laryngeal voice apparatus. It can be used in complex treatment of paralyses and larynx paresis.

Article Details

How to Cite
Voitenko, V., and V. Palamarchuk. “Potential of Comprehensive Medical Treatment of Complex Laryngeal Nerve Injuries in Thyroid Surgery”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), no. 4.76, Aug. 2016, pp. 108-11, doi:10.22141/2224-0721.4.76.2016.77822.
Endocrine Surgery


Savenok AV. Parezy i paralichi gortani (Paresis and paralysis of the larynx). Klinicheskie rekomendacii. Khabarovsk. 2014. 3 p. Russian.

Banar I.M. Mikrohirurgiya pri ustranenii paraliticheskih stenozov gortani: Tesisi dokladov na IX sezde otolaringologov SSSR. Kishenev. 1988. 314-315 p. Russian.

Continuous laryngeal nerve integrity monitoring during thyroidectomy: does it reduce risk of injury? ML. Robertson et al. Otolaryngol Head Neck Surg. 2004;131 (5): 596-600.

Rjabova MA. Vosstanovlenie golosa u bol'nyh s odnostoronnimi paralichami gortani (Restoration of voting in patients with unilateral paralysis of the larynx). Rjabova MA, Solov'eva EA, Temiraeva ZK. Golos i rech', 2010;1: 54-55. Russian.

Procacciante F. Palpatory method used to identify the recurrent laryngeal nerve during thyroidectomy. World J Surg. 2001; 25 (2):252-253.

Valdina E.A. Zabolevaniya tchitovidnoy gelezy (thyroid disease). SPb. 2006. p. 368.

Vasilenko Ju S. Golos. Foniatricheskie aspekty (vote. foniatricheskie aspects). M., 2013. 207 p. Russian.

Crumley RL. Laryngeal synkinesis:its significance to the laryngologist. Ann. Otol. Rhinol. Laryngol. 1989;98:87-92.

Crumley RL. Unilateral recurrent laryngeal nerve paralyses. J. Voice. 1994;8:79-83.

Temiraeva ZK. Algoritm obsledovanija i kompleksnoe lechenie bol'nyh odnostoronnimi paralichami gortani (The algorithm of examination and complex treatment of patients with unilateral paralysis of the larynx). Ross. Otorhinolarigol. 2009;1(38):143-148.

Nikitin KA, Bachegova EM, Kotel'nikova DA. Novye podhody k provedeniju patogeneticheskoy terapii pri perefericheskih poragenijah cherepnyh nervov v otorinolaringologii (new approaches to pathogenetic therapy for peripheral lesions of the cranial nerves in otorhinolaryngology). Vestn. Otorinolaringol. 2008;4:45.