Recovery of vocal cord function after thyroid lobectomy for hashimoto’s thyroiditis

Abstract Objectives: Chronic lymphocytic thyroiditis or Hashimoto’s thyroiditis is a well-described autoimmune thyroid disorder. The purpose of this case report is to describe a patient presenting with vocal cord paralysis and Hashimoto’s thyroiditis who spontaneously recovered function after surgery. Options for management of a paralyzed vocal cord are reviewed. Methods: A 29-year-old man presented with 3 months of hoarseness. Indirect laryngoscopy showed a paralyzed left vocal cord. Imaging studies demonstrated a left thyroid mass. Left thyroid lobectomy was performed. Postoperative course was uneventful. Results: Pathologic study revealed chronic lymphocytic thyroiditis with no malignancy identified. Spontaneous recovery of vocal cord function was seen at 1 month after surgery with improvement in voice quality and limited return of mobility. Complete resolution of paralysis was seen by 2 months. Follow-up at 3 months demonstrates no deterioration of vocal cord mobility. Conclusion: Vocal cord paralysis may rarely be associated with benign thyroid processes, although it is seen much more commonly in conjunction with malignancy. In such a clinical situation, therefore, malignancy must be excluded. Review of the literature shows vocal cord paralysis in association with Hashimoto’s thyroiditis to be quite uncommon. This case demonstrates the prudence of a time of postoperative observation to allow for return of function prior to consideration of medialization techniques.