<em>Decision-IQ</em>: Select Strategies in the Prevention, Detection, and Treatment of Nerve Injury During Thyroidectomy

Decision-IQ: Select Strategies in the Prevention, Detection, and Treatment of Nerve Injury During Thyroidectomy

Expiring Soon

Developed in collaboration
Med-IQ      Duke Medicine

Online Course | Specialties: Otolaryngology
Released: 2/4/2021
Expires: 2/3/2022
Max Credits: 0.25
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Alissa Collins, MD
Assistant Professor of Head and Neck Surgery and Communication Sciences
Duke University School of Medicine
Durham, NC

Daniel Rocke, MD, JD, FACS
Assistant Professor
Duke University Medical Center
Department of Head and Neck Surgery and Communication Sciences
Durham, NC
Activity Planners
Christie Avraamides, PhD
Clinical Content Manager
Baltimore, MD

Lisa R. Rinehart, MS, ELS
Director, Editorial Services
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager
Baltimore, MD

Amy Sison
Director of CME
Baltimore, MD
Learning Objective
Upon completion, participants should be able to:

  • Discuss how to prevent, diagnose, and treat nerve injuries following thyroid surgery

Target Audience
This activity is intended for ENTs and general surgeons.
Statement of Need
Thyroid surgery rates have increased over the past 3 decades; in 2012, it is estimated that 118,000-166,000 thyroid surgeries were performed. After thyroid surgery, approximately 1 in 10 patients experience temporary laryngeal nerve injury, with 1 in 25 experiencing longer-lasting voice problems. Because voice problems can substantially affect quality of life, early recognition of laryngeal dysfunction after thyroid surgery is important. ENTs and general surgeons must be aware of preoperative guidelines for patients who are undergoing thyroid surgery and identify appropriate management approaches when patients present postoperatively with symptoms concerning vocal fold paralysis.   

Collaborator Statement
This activity was developed by Med-IQ in collaboration with Duke Health. 
Med-IQ      Duke Medicine
Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Med-IQ designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse practitioners, physician assistants, and other healthcare professionals who successfully complete the activity will receive a Statement of Participation indicating the maximum credits available. 
Medium/Method of Participation
This CME activity consists of a 0.25-credit online publication. To receive credit, read the introductory CME material, read the publication, and complete the post-survey, evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.  
Initial Release Date: February 4, 2021
Expiration Date: February 3, 2022
Estimated Time to Complete This Activity: 15 minutes

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Med-IQ requires any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as those in any amount occurring within the past 12 months, including those of a spouse/life partner, that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation. 

Alissa Collins, MD, has indicated no real or apparent conflicts.

Daniel Rocke, MD, JD, FACS, has indicated no real or apparent conflicts.

The peer reviewers and activity planners have no financial relationships to disclose. 
Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, it is the policy of Med-IQ to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.
Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.
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For questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or email

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Here are the key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available at the "Continue" button below.

  • The American Head and Neck Society recommends that all patients undergoing thyroid surgery who have a high risk of nerve injury undergo preoperative laryngeal examination
  • The early recognition of neural injury after thyroid surgery allows for earlier opportunities for interventions that can improve vocal outcomes and quality of life
  • Vocal fold mobility should be evaluated in patients who are experiencing dysphagia or hoarseness 2 weeks after thyroid surgery
  • Patients with symptomatic vocal fold paralysis can be managed with injection laryngoplasty

View reference list.

Click “Continue” to proceed through this activity and/or receive credit. To receive credit and a certificate, you must complete all of the chapters in this activity.

By clicking "Continue," you confirm that you have reviewed the CME information.


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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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