Neuromuscular electrophonopedic stimulation of the larynx after surgical treatment of patients with differentiated thyroid cancer

Abstract

BACKGROUND: Thyroid cancer is the most common endocrine malignancy, accounting for 3.4% of all cancers diagnosed annually. Differentiated thyroid cancer (DTC) is primarily treated with surgery, which can often involve complications such as postoperative pareses or reversible laryngeal nerve (RLN) paralysis. Currently, rehabilitation possibilities for patients with postoperative RLN pairs are relevant. In this study, we used neuromuscular electrostimulation with vocaSTIM in combination with drug therapy and evaluated the effectiveness of the rehabilitation. AIMS: To determine the possibility of using neuromuscular electrophonopathic laryngeal stimulation (NMELS) in restoring laryngeal function after surgical treatment of DTC complicated by pareses/paralysis of thr RLN. MATERIALS AND METHODS: Seventy-six patients with DTC who have undergone surgical treatment, complicated by paresis of RLN, were enrolled in this study. RESULTS: The study analyzed the treatment results of these 76 patients. The age of the patients ranged from 6 to 78 (average age, 47) years, the female-to-male ratio was 59 to 17 (women, 77.6%; men, 22.4%). Postoperative unilateral laryngeal paresis was present in 56 patients (73.68%) and bilateral lesions in 20 (26.32%). Phonation violation was found in all patients: dysphonia, 76 (100%); dysphagia, 28 (36.84%); and respiratory failure, 11 (14.47%), and 2 patients (2.63%) were tracheotomized postoperatively. All patients underwent neuro-phonic rehabilitation with mandatory assessment and video fixation of laryngeal function. As a result of neuromuscular electrophonopathic stimulation of the larynx, 69 out of 76 patients (90.79%) had improved larynx function. CONCLUSIONS: Based on our experience, NMELS with vocaSTIM can be used for restoring the functions of the larynx in patients with RLN paresis of varying severities, after surgical treatment for DTC.