Hoarseness after radical surgery with systematic lymph node dissection for primary lung cancer

Yoshifumi Sano, Hisayuki Shigematsu, Mikio Okazaki, Nobuhiko Sakao, Yu Mori, Shungo Yukumi, Hironori Izutani

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


OBJECTIVES: Radical surgery with systematic upper mediastinal node dissection for primary lung cancer can cause recurrent laryngeal nerve (RLN) paralysis, but this is poorly reported. METHODS: We retrospectively reviewed the clinical data for consecutive patients who underwent radical surgery for primary lung cancer with an observation period of at least 12 months. During follow-up, hoarseness and vocal fold movement were assessed clinically and laryngoscopically, respectively. RESULTS: Of the 365 patients included in this study, 22 (6.0%) experienced hoarseness as a complication. All 22 patients who experienced hoarseness had undergone upper mediastinal node dissection. Although 1 of the 22 patients refused to undergo laryngoscopy, we assessed the vocal fold movement in the remaining patients (95.5%). Among these, 5 patients (23.8%) had right RLN paralysis, and 15 (71.4%) had left RLN paralysis and showed no sign of RLN paralysis. Over 1-24 months, vocal cord movement improved in 61.1% (11/18); and over 1-28 months, hoarseness improved in 72.7% (16/22). All patients with right RLN paralysis improved without further treatment. CONCLUSIONS: We conclude that extensive follow-up is necessary to discern whether hoarseness is a temporary or permanent complication of radical surgery in patients with primary lung cancer who have undergone systematic lymph node dissection.

Original languageEnglish
Pages (from-to)280-285
Number of pages6
JournalEuropean Journal of Cardio-Thoracic Surgery
Issue number2
Publication statusPublished - Feb 1 2019
Externally publishedYes


  • Hoarseness
  • Primary lung cancer
  • Recurrent laryngeal nerve paralysis
  • Systematic lymph node dissection

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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