Thyroid : official journal of the American Thyroid Association
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Surgeons may assume intuitively that preservation of a palsied recurrent laryngeal nerve (RLN) in patients with preoperative vocal cord paralysis is not meaningful. Here we present our experience in four cases with preoperative vocal cord paralysis, and show that preservation of a palsied RLN may be important in maintaining patients' voice. ⋯ Even on a palsied RLN, a positive electrophysiological response may still be yielded by intraoperative neuromonitoring. This means that there may retain residual innervations in laryngeal muscles. To prevent atrophy of a paralyzed vocal cord, further injury to a palsied RLN should be avoided. Even the palsied nerve should be saved whenever possible.
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Controlled Clinical Trial
Serial changes in liver function tests in patients with thyrotoxicosis induced by Graves' disease and painless thyroiditis.
When the liver function tests are aggravated after starting antithyroid drugs (ATDs) in Graves' hyperthyroidism, discontinuation of ATDs is generally considered. However, a question arises whether such aggravation constitutes an adverse effect of the drugs or not. ⋯ Similar serial changes in liver function tests in both Graves' disease and painless thyroiditis strongly suggest that increases of AST and ALT after starting ATD therapy may not be due to ATD side effects but may be induced by changes in thyroid function.