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The American Thyroid Association Guidelines on Voice Assessment—Have We Done Enough?

David C. Shonka Jr, MD1; David J. Terris, MD2
[+] Author Affiliations
1Department of Otolaryngology–Head and Neck Surgery, University of Virginia Health System, Charlottesville
2GRU Thyroid Center, Georgia Regents University, Augusta
JAMA Otolaryngol Head Neck Surg. 2016;142(2):115-116. doi:10.1001/jamaoto.2015.3222.
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This Viewpoint examines new American Thyroid Association guidelines that recommend a preoperative voice assessment for all patients undergoing thyroid surgery and suggests that the guidelines are deficient in their selective approach to preoperative and postoperative laryngeal examination.

For the first time since their inception, the American Thyroid Association (ATA) guidelines include a recommendation regarding voice assessment as it pertains to thyroid surgery.1 This marks a distinct change from the 2009 guidelines, which do not mention voice assessment or laryngeal examination. The current guidelines recommend a preoperative voice assessment for all patients undergoing thyroid surgery. Furthermore, a preoperative laryngeal examination is recommended in certain situations: patients with preoperative voice changes, a history of neck or chest surgery, a posteriorly located thyroid cancer, or extensive central compartment nodal disease. The guidelines also recommend that all patients have a postoperative voice assessment, with formal laryngeal examination reserved for patients with voice complaints. This addition to the most recent ATA guidelines marks an important step in the right direction.

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