Background
Voice and throat dysfunction may occur in patients after thyroidectomy, even in the
absence of apparent laryngeal nerve injury. We evaluated the impact of thyroid surgery
on voice and throat function using perceptive, objective, and subjective measurements
in a prospectively enrolled and serially followed cohort of thyroid cancer patients.
We assessed the impact of surgical extent and intensity of postoperative treatment,
including addition radioactive iodine treatment (RIT), on these functions.
Methods
Consenting patients undergoing thyroid lobectomy (TL; n = 33), total thyroidectomy (TT; n = 41), or TT plus RIT (n = 81), none of whom had laryngeal nerve dysfunction perioperatively, were enrolled
prospectively. All underwent comprehensive functional evaluations, including perceptive
voice quality using the grade, roughness, breathiness, asthenia, strain (GRBAS) scale
and acoustic voice analysis with multiple parameters, and filled out subjective questionnaires,
including the Voice Handicap Index (VHI) and the Glasgow Edinburgh Throat Scale, before
thyroidectomy and at 1, 6, and 12 months postoperatively.
Results
In this study, 14–83% of the patients developed some element of voice and throat dysfunction,
shown consistently in different evaluations. Typical patterns were alterations of
perceptive voice, deranged acoustic parameters, and subjective worsening on the VHI
and GETS. Moreover, these changes were correlated with the extent of treatment, especially
within 3 months after operation, and often persisted 12 months postoperatively. RIT
had no effects on voice outcomes throughout the follow-up.
Conclusion
Voice and throat dysfunction are evident after thyroidectomy, more severely after
TT than TL. These potential disabilities should be considered carefully to further
enhance patients' quality of life.
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Article info
Publication history
Published online: August 12, 2013
Accepted:
March 28,
2013
Identification
Copyright
© 2013 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
