Prospective voice assessment after uncomplicated thyroidectomy: A comprehensive analysis of a single centre experience

• Published in: Clinical otolaryngology Vol. 48; no. 1; pp. 39 - 49
• Main Authors: Nam, Inn‐Chul, Bae, Ja‐Seong, Lee, So‐Hee, Kim, Jeong‐Soo, Hwang, Yeon‐Shin, Shim, Mi‐Ran, Kim, Geun‐Jeon, Park, Jun‐Ook, Park, Young‐Hak, Sun, Dong‐Il
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-01-2023
• Subjects: Dissection; Dysphonia; extent of surgery; Frequency ranges; Humans; Medical records; Parameters; Patients; Pattern analysis; Prospective Studies; questionnaire; Retrospective Studies; Surgery; Thyroid; Thyroidectomy; Thyroidectomy - adverse effects; Thyroidectomy - methods; Voice; voice change; Voice Disorders - diagnosis; Voice Disorders - etiology; voice evaluation; Voice Quality; voice evaluation; voice change; questionnaire; thyroidectomy; extent of surgery
• ISSN: 1749-4478; 1749-4486
• DOI: 10.1111/coa.13995

Objectives
Voice change after uncomplicated thyroidectomy has been an important issue in the field of thyroid surgery. The aim of this study was to promote understanding of voice change after uncomplicated thyroidectomy by analysing the results for a large number of patients from a single institute.
Design
We retrospectively reviewed the medical records of 2879 consecutive patients who underwent thyroidectomy and voice evaluation between January 2014 and December 2019 in a single institute. All the patients had their vocal status assessed using videostroboscopy, acoustic voice analyses, aerodynamic study, and Thyroidectomy‐related Voice and Symptom Questionnaire (TVSQ) scores preoperatively and at 1, 3, and 6 months postoperatively. We analysed the pattern of voice changes over time and differences in voice parameters based on clinical factors. To confirm the usefulness of the TVSQ, the correlation between TVSQ scores and objective parameters was analysed. Lastly, predictive factors for persistent voice symptoms were analysed.
Setting
Tertiary referral hospital.
Results
The frequency ranges and TVSQ scores exhibited significant deterioration until 6 months following surgery. Among clinical factors, the extents of thyroidectomy and neck dissection were associated with worse voice parameters. The TVSQ score was significantly correlated with objective voice parameters. The extents of thyroidectomy and neck dissection were predictive of persistent voice symptoms at 6 months after thyroidectomy.
Conclusion
After uncomplicated thyroidectomy, most voice parameters tended to recover, but some parameters remained aggravated even at 6 months after surgery. With more extensive surgery, worse voice quality and the higher risk of persistent voice symptoms may be anticipated.