Diagnosis of recurrent laryngeal nerve palsy after thyroidectomy: a systematic review

Background: Recurrent laryngeal nerve palsy (RLNP) is a recognised possible complication after thyroid surgery. It may present with a variety of symptoms, such as voice change and respiratory symptoms. However, it may remain undetected and the true incidence may be under‐reported. The aim of this study was to determine the reported incidence of temporary and permanent palsy after thyroid surgery using different vocal assessment methods. Methods: A Medline search was performed. A systematic review was undertaken which included 27 articles and 25,000 patients. Results: The average incidence of temporary RLNP after thyroid operations is 9.8% and the incidence of permanent RLNP is 2.3%. The RLNP rate varied according to the method of examining the larynx and ranged from 26% to 2.3%. Most of the reviewed studies recommend a follow‐up period up to 1 year to assess and evaluate RLNP. Conclusion: Our study has identified that different methods are used to diagnose RNLP and that a wide variety of reported RLNP rates exist. We propose establishment of a ‘gold standard’ for assessing the voice after thyroidectomy to reduce reporting bias.     

The relationship between personality traits,pain perception and attitude toward orthodontic treatment

Objective:To investigate the relationship between personality traits and a person''s attitude toward orthodontic treatment and perception of pain during orthodontic treatment.Materials and Methods:The sample consisted of two groups: group 1 consisted of 200 untreated subjects (100 males, 100 females; average age, 21.50 ± 3.35 years), and group 2 consisted of 200 treated subjects (100 males, 100 females; average age, 20.92 ± 2.48 years). The instrument for data collection was a questionnaire that included assessment of patients'' personality profiles, pain expectation for untreated subjects, pain experience for treated subjects, and attitudes toward orthodontic treatment.Results:Gender, treatment status, and personality traits did not affect subjects'' average attitude toward orthodontic treatment, whereas gender was the only variable that affected subjects'' average pain perception (P < .01). The average attitude score in subjects who experienced pain during orthodontic treatment was 5.06 ± 1.43, compared to 4.32 ± 1.35 for subjects who did not experience pain (P < .001). The average pain perception scores in treated subjects with previous knowledge of orthodontic treatment was 5.29 ± 1.94, compared to 6.07 ± 1.95 in subjects who did not have previous knowledge of orthodontic treatment (P < .01).Conclusions:Personality traits did not affect attitude toward orthodontic treatment and pain perception/experience during orthodontic treatment. A more positive attitude was found in patients who experienced less pain during orthodontic treatment.