Preserving the Voice: Insights from Dr. Vaninder Dhillon on Thyroid Surgery and Ablation

In a recent episode of the Doctor Thyroid and RFAMD podcasts, Dr. Vaninder Dhillon, an esteemed laryngologist and ENT surgeon from Johns Hopkins, highlighted the critical issue of voice and swallow risks associated with thyroidectomy and thyroid ablation.

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The interview sheds light on the importance of preserving the voice and offered insights into innovative approaches to avoid surgery.

Dr. Dhillon, who has extensive experience in both laryngology and endocrine head and neck surgery, underscored the significance of the voice and swallow outcomes in patients undergoing these procedures. Her research and clinical practice focus on improving outcomes and quality of life for patients who may face post-operative issues with their voice and swallow, as well as those with general voice and swallow complaints.

One of the most common complications after thyroid surgery is vocal cord paralysis, which can have a significant impact on a patient's voice. While the overall percentage of patients experiencing voice issues after thyroidectomy varies, it can be as high as 30 to 50 percent, with temporary paralysis affecting up to 15 percent. Although permanent paralysis is rarer (1-2 percent), it remains a concern for patients.

During the interview, Dr. Dhillon emphasized the importance of differentiating between voice and swallowing outcomes, as the latter is often overlooked. Swallowing complaints are higher than voice complaints, with some studies showing up to 60 percent of patients experiencing temporary swallowing issues post-operatively.

Voice and swallow assessments are crucial before and after surgery. Dr. Dhillon stressed the need for a comprehensive evaluation, including endoscopy and video stroboscopy, to examine the larynx more closely during speech. These assessments help in identifying potential issues with the recurrent laryngeal nerve and the superior laryngeal nerve.

Dr. Dhillon's team has implemented voice and swallow tests before surgery, and they continue to monitor patients post-operatively to ensure any issues are addressed promptly. This pro