Transient vocal cord paralysis after fine-needle aspiration biopsy of thyroid tumor.

OBJECTIVE: Complications of thyroid fine-needle aspiration biopsy (FNAB) are exceedingly rare. Hematoma formation is the most commonly encountered complication. Infection and seeding of carcinoma cells in the needle track has also been reported in a rare case. Here we describe patients diagnosed as having transient vocal cord paralysis after FNAB of benign thyroid tumor.

DESIGN: Retrospective review of patients with concurrent diagnosis of vocal cord paralysis after FNAB.

MAIN OUTCOME: Among 10,974 patients who underwent FNAB, 4 patients showed vocal cord paralysis on laryngoscopy. These patients had solid and/or cystic lesion in the thyroid. Routine FNAB of the nodule was performed using a 23-gauge needle. Cytologic findings were benign tumor. Change of voice in the patients occurred 1 or 2 days after FNAB and vocal cord paralysis ipsilateral to FNAB was determined by flexible laryngoscopy. Vocal cord paralysis of all patients resolved spontaneously within 6 months (average, 4 months).

CONCLUSION: Although the incidence of vocal cord paralysis in patients with thyroid tumor after FNAB is reported to be 0.036%, the true incidence is unknown because asymptomatic subjects are not screened. This report should alert the examiner to the possibility of vocal cord palsy after FNAB.