Background
Voice and swallowing symptoms are frequently reported early after thyroidectomy even
in the absence of laryngeal nerves injury. We evaluated the short-term and long-term
outcomes of these functional alterations.
Methods
Consenting patients undergoing total thyroidectomy (TT) were enrolled. Videolaryngostroboscopy
(VSL), acoustic voice analysis (AVA), and maximum phonation time (MPT) were performed
pre-operatively, 3 months postoperatively, and >1 year postoperatively. Subjective
evaluation of voice (Voice Impairment Score=VIS) and swallowing (Swallowing Impairment Score=SIS) were obtained pre-operatively, as well as 1 week, 1 month, 3 months, and >1 year
postoperatively.
Results
The long-term evaluation was completed in 110 patients. The percentage of patients
with symptoms 1 week after operation was significantly higher than preoperatively,
whereas it was significantly lower at long-term evaluation. VIS was significantly
worse than pre-operatively, 1 week, 1 month, and 3 months after surgery, but it was
similar to pre-operative >1 year after TT. SIS was significantly worse 1 week after
thyroidectomy but not 1 month and 3 months after thyroidectomy, and it was significantly
lower than the pre-operative >1 year after TT.
Conclusion
Vocal and swallowing symptoms are frequent after TT. In the absence of laryngeal nerve
injury, after an initial impairment, late after operation, patients experienced subjective
amelioration of their voice and swallowing performances, which may be related to the
resolution of compressive symptoms.
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References
- Recurrent laryngeal nerve damage and phonetic modifications after total thyroidectomy: surgical malpractice only or predictable sequence?.World J Surg. 2005; 29: 780-784
- Prevalence of long-term upper aero-digestive symptoms after uncomplicated bilateral thyroidectomy.Surgery. 2003; 133: 318-322
- Prospective functional voice assessment in patients undergoing thyroid surgery.Ann Surg. 2002; 236: 823-832
- Voice changes after thyroidectomy recurrent laryngeal nerve injury.J Am Coll Surg. 2004; 199: 556-560
- Intraoperative monitoring of the recurrent laryngeal nerve in thyroid surgery.World J Surg. 2008; 32: 1358-1366
- Anatomical and surgical considerations of the external branch of the superior laryngeal nerve: a systematic review.Clin Otolaryngol. 2006; 31: 368-374
- Is the identification of the external branch of the superior laryngeal nerve mandatory in thyroid operation? Results of a prospective randomized study.Surgery. 2001; 130: 1055-1059
- Surgical anatomy of the recurrent laryngeal nerve.in: Randolph G.W. Surgery of the thyroid and parathyroid glands. Saunders, Philadelphia, PA2003: 300-342
- Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuries.Surgery. 2006; 140: 1026-1034
- Phonatory characteristics of patients undergoing thyroidectomy without laryngeal nerve injury.Otolaryngol Head Neck Surg. 1997; 117: 399-404
- Acoustic analysis of the speaking voice after thyroidectomy.J Voice. 1997; 11: 479-482
- Thyroid surgery and voice-related outcomes.Aust N Z J Surg. 2000; 70: 179-183
- The functional impact on voice of sternothyroid muscle division during thyroidectomy.Ann Surg Oncol. 2008; 15: 2027-2033
- A multivariate analysis of objective voice changes after thyroidectomy without laryngeal nerve injury.Arch Otolaryngol Head Neck Surg. 2008; 134: 596-602
- Prospective trial of voice outcome after thyroidectomy: evaluation of patients-reported voice assessments in identifying postthyroidectomy dysfonia.Surgery. 2008; 143: 732-742
- Video-assisted thyroidectomy: report on the experience of a single center in more than four hundred cases.World J Surg. 2006; 30: 794-800
- Video-assisted thyroidectomy significantly reduces the risk of early postthyroidectomy voice and swallowing symptoms.World J Surg. 2008; 32: 693-700
- Changes of the speaking and singing voice after thyroid or parathyroid surgery.Surgery. 2006; 140: 978-989
- The evaluation of the causes of subjective voice disturbances after thyroid surgery.Am J Surg. 2007; 194: 317-322
- Voice and vocal self-assessment after thyroidectomy.Head Neck. 2006; 28: 1106-1114
- Objective voice measures in nonsinging patients with unilateral superior laryngeal nerve paresis.J Voice. 2005; 19: 665-667
- Expression or emotion in voice and music.J Voice. 1995; 9: 235-248
Article info
Publication history
Accepted:
September 17,
2009
Identification
Copyright
© 2009 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
