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One of the unpleasant complications of operation on the thyroid gland is an injury of the recurrent laryngeal nerve with its sequels in the larynx, which commonly manifests itself as a loss of voice or difficulty of breathing. The paralysis of one vocal cord may pass unnoticed by the average clinician and many times has no further bearing on the case unless the cord is paralyzed in the so-called cadaveric position, in which case the patient will have a hoarse or husky voice.
If both cords are paralyzed, though the voice may be normal, the patient's life may be endangered because of insufficient breathing space. Most surgeons are concerned over the loss of voice. This is an entirely wrong conception. If the patient is hoarse, it means there is sufficient area for breathing between the two cords, but if the voice is good and the patient makes noise while sleeping
LASZLO AF, FIERTZ CO. PROGNOSIS OF THE RECURRENT NERVE PARALYSIS FOLLOWING THYROIDECTOMY. Arch Otolaryngol. 1945;42(5):372–373. doi:10.1001/archotol.1945.00680040492005
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