Quantitative study of voice dysfunction after thyroidectomy

Background Up to 80% of patients without a recurrent laryngeal nerve palsy report alteration in their voice after a thyroid procedure. The aims of this study were (1) to quantify voice changes after thyroid operation; (2) to correlate the changes to the extent of operation; and (3) to correlate voic...

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Bibliographic Details
Published in:Surgery 2016-12, Vol.160 (6), p.1576-1581
Main Authors: Lee, James C., MBBS, FRACS, PhD, Breen, Daniel, MBBS, Scott, Amanda, PhD, Grodski, Simon, MBBS, FRACS, Yeung, Meei, MBBS, BMedSci, FRACS, Johnson, William, MBBS, MD, FRACS, FACS, Serpell, Jonathan, MBBS, MD, MEd, FRACS, FACS
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications - diagnosis
Postoperative Complications - etiology
Prospective Studies
Recurrent Laryngeal Nerve Injuries - diagnosis
Recurrent Laryngeal Nerve Injuries - etiology
Remission, Spontaneous
Severity of Illness Index
Surgery
Thyroid Diseases - surgery
Thyroidectomy - adverse effects
Treatment Outcome
Voice Disorders - diagnosis
Voice Disorders - etiology
Voice Quality
Young Adult
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Summary:Background Up to 80% of patients without a recurrent laryngeal nerve palsy report alteration in their voice after a thyroid procedure. The aims of this study were (1) to quantify voice changes after thyroid operation; (2) to correlate the changes to the extent of operation; and (3) to correlate voice changes to intraoperative recurrent laryngeal nerve swelling. Methods Patients undergoing total and hemithyroidectomy were recruited prospectively from the Monash University Endocrine Surgery Unit during a 12-month period. Voice quality was scored subjectively using the Voice Disorder Index (score 0–40, from best to worst) and objectively using the Dysphonia Severity Index (score −5 to 5, from worst to best), before and after operation. These assessments were carried out by 2 speech pathologists. Recurrent laryngeal nerve diameter was measured intraoperatively at the commencement and conclusion of the lobectomy, using Vernier calipers with a resolution of 0.1 mm. Statistical methods used included Student t test, χ2 , Wilcoxon signed-rank test, and linear regression. Results A total of 62 patients were included in the study, with a mean age of 48 ± 16 years and a female preponderance (6:1). Overall, the voice quality deteriorated both subjectively (mean Voice Disorder Index 4.2 ± 0.8–9.4 ± 1.2, P  
ISSN:0039-6060
1532-7361
DOI:10.1016/j.surg.2016.07.015