After thyroidectomy, which statement best describes the expected course of hoarseness?

• A. It will worsen before it subsides.
• B. It is normal and will gradually subside.
• C. It indicates permanent nerve damage.
• D. It will be immediate and permanent.

Answer: (B)

Hoarseness after thyroidectomy is most often due to temporary irritation or stretching of the recurrent laryngeal nerve and postoperative swelling affecting the vocal cords. Because this nerve injury is typically neuropraxia and swelling resolves with time, voice function usually improves as healing progresses. So the expected course is that the hoarseness is a normal, temporary finding that gradually subsides. It does not usually worsen first, and it is not expected to be permanent right away; if hoarseness persists long enough to raise concern for permanent nerve injury, that would prompt further evaluation, but that isn’t the typical immediate course.