Intraoperative Corticosteroids for Voice Outcomes among Patients Undergoing Thyroidectomy: A Systematic Review and Meta-analysis

Julia E. Noel, Maxwell P. Kligerman, Uchechukwu C. Megwalu

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Objective: To determine if a preoperative dose of intravenous corticosteroids reduces the risk of postoperative recurrent laryngeal nerve palsy and improves subjective voice outcomes among patients undergoing thyroidectomy. Data Sources: PubMed, Cochrane database, and EMBASE. Review Methods: Randomized controlled trials comparing corticosteroids with placebo on voice outcomes in thyroid surgery were extracted with standardized search criteria. Systematic review and meta-analysis were performed. With random effects models, trial data were pooled to determine the overall rate of recurrent laryngeal nerve palsy as well as secondary outcomes of adverse events, including wound infection and hyperglycemia. Results: Four studies with a total of 517 patients met inclusion criteria. The overall rate of recurrent laryngeal nerve palsy was 5.78%. There was no difference in the rate of palsy between the corticosteroid and placebo groups (risk ratio, 0.70; 95% CI, 0.34-1.44). There was also no difference between the groups in regard to wound infection, healing, or hyperglycemia. Conclusions: Preoperative corticosteroids do not appear to reduce the risk of recurrent laryngeal nerve palsy following thyroid surgery. There is insufficient evidence to assess its effect on subjective voice outcomes. More robust randomized controlled trials are needed to assess the effectiveness of perioperative steroids in improving voice outcomes after thyroidectomy.

Original languageEnglish
Pages (from-to)811-816
Number of pages6
JournalOtolaryngology - Head and Neck Surgery
Volume159
Issue number5
DOIs
StatePublished - 1 Nov 2018
Externally publishedYes

Keywords

  • corticosteroids
  • hoarseness
  • laryngeal nerves
  • thyroidectomy
  • voice

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