Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
권호 표지
DOI QR코드

DOI QR Code

Impact of anxiety on voice after thyroidectomy : a preliminary study

갑상선 수술 전 환자의 불안 정도가 수술 후 음성에 미치는 영향 : 예비연구

  • Lee, Hyoung Shin (Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine) ;
  • Lee, Sang Shin (Department of Psychiatry, Kosin University College of Medicine) ;
  • Kim, Hwa Bin (Department of Medicine, Kosin University College of Medicine) ;
  • Oh, Dasol (Department of Medicine, Kosin University College of Medicine) ;
  • Kim, Ji Su (Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine) ;
  • Jeon, Suk Won (Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine) ;
  • Kim, Sung Won (Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine) ;
  • Lee, Kang Dae (Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine)
  • 이형신 (고신대학교 의과대학 이비인후과학교실) ;
  • 이상신 (고신대학교 의과대학 정신건강의학과교실) ;
  • 김화빈 (고신대학교 의과대학 의학과) ;
  • 오다솔 (고신대학교 의과대학 의학과) ;
  • 김지수 (고신대학교 의과대학 이비인후과학교실) ;
  • 전석원 (고신대학교 의과대학 이비인후과학교실) ;
  • 김성원 (고신대학교 의과대학 이비인후과학교실) ;
  • 이강대 (고신대학교 의과대학 이비인후과학교실)
  • Received : 2017.10.23
  • Accepted : 2017.11.04
  • Published : 2017.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background and Objectives: Voice change after thyroidectomy may develop without injury of recurrent laryngeal nerve. Psychogenic or emotional factors related to voice change after thyroidectomy has been rarely studied. In this study, we sought to analyze the impact of anxiety on early state of post-thyroidectomy voice change. Materials and Methods: We made a retrospective chart review of 36 patients who underwent thyroidectomy for papillary thyroid carcinoma and voice exam before surgery, 2 weeks after and 1 month after surgery. All patients included in the study answered a questionnaire for State-Trait Anxiety Inventory ; STAI-KYZ (form Korean YZ). Clinico-pathologic factors and parameters of voice analysis were reviewed to analyze correlation to the anxiety index. Results: No differences were identified between clinicopathologic factors and preoperative parameters of voice analysis between patients with higher and lower level of anxiety. Noise to harmonic ratio (NHR) was higher in those patients with higher level of anxiety, 2 weeks after surgery (p=0.043). However, none of the parameters showed any difference 1 month later. Conclusion: With limited number of patients and short period of follow up, significant impact of preoperative anxiety on postoperative voice change after thyroidectomy could not be identified in this preliminary study.

Keywords

References

  1. Kuhn MA, Bloom G, Myssiorek D. Patient Perspectives on Dysphonia After Thyroidectomy for Thyroid Cancer. J Voice. 2013;27:111-114. https://doi.org/10.1016/j.jvoice.2012.07.012
  2. Sinagra DL, Montesinos MR, Tacchi VA, Moreno JC, Falco JE, Mezzadri NA, et al. Voice changes after thyroidectomy without recurrent laryngeal nerve injury. J Am Coll Surg. 2004;199: 556-560. https://doi.org/10.1016/j.jamcollsurg.2004.06.020
  3. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26:1-133. https://doi.org/10.1089/thy.2015.0020
  4. Bilimoria KY, Bentrem DJ, Ko CY, Stewart AK, Winchester DP, Talamonti MS, et al. Extent of surgery affects survival for papillary thyroid cancer. Ann Surg. 2007;246:375-381; discussion 381-374. https://doi.org/10.1097/SLA.0b013e31814697d9
  5. Stojadinovic A, Shaha AR, Orlikoff RF, Nissan A, Kornak M-F, Singh B, et al. Prospective functional voice assessment in patients undergoing thyroid surgery. Ann Surg. 2002;236:823. https://doi.org/10.1097/00000658-200212000-00015
  6. Debruyne F, Ostyn F, Delaere P, Wellens W. Acoustic analysis of the speaking voice after thyroidectomy. J Voice. 1997;11:479-482. https://doi.org/10.1016/S0892-1997(97)80046-X
  7. Park JO, Bae JS, Chae BJ, Kim CS, Nam IC, Chun BJ, et al. How can we screen voice problems effectively in patients undergoing thyroid surgery? Thyroid. 2013;23:1437-1444. https://doi.org/10.1089/thy.2013.0262
  8. Elam JC, Ishman SL, Dunbar KB, Clarke JO, Gourin CG. The relationship between depressive symptoms and Voice Handicap Index scores in laryngopharyngeal reflux. Laryngoscope. 2010; 120:1900-1903. https://doi.org/10.1002/lary.21012
  9. Dietrich M, Verdolini Abbott K. Vocal function in introverts and extraverts during a psychological stress reactivity protocol. J Speech Lang Hear Res. 2012;55:973-987. https://doi.org/10.1044/1092-4388(2011/10-0344)
  10. Nerurkar NK, Kapre GM, Kothari NN. Correlation between personality type and vocal pathology: A nonrandomized case control study. Laryngoscope. 2016;126:2063-2066. https://doi.org/10.1002/lary.25810
  11. Martinez CC, Cassol M. Measurement of Voice Quality, Anxiety and Depression Symptoms After Speech Therapy. J Voice. 2015; 29:446-449. https://doi.org/10.1016/j.jvoice.2014.09.004
  12. 한덕운, 이장호, 구겸구. 상태-특성불안 검사 YZ형 실시와 사용설명서. 서울:학지사. 2000:7-14.
  13. Lombardi CP, Raffaelli M, D'Alatri L, Marchese MR, Rigante M, Paludetti G, et al. Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuries. Surgery. 2006;140:1026-1034. https://doi.org/10.1016/j.surg.2006.08.008
  14. Bhattacharyya N, Fried MP. Assessment of the morbidity and complications of total thyroidectomy. Arch Otolaryngo Head Neck Surg. 2002;128:389. https://doi.org/10.1001/archotol.128.4.389
  15. Lee HS, Kim SW, Park HS, Park CW, Kim JS, Hong JC, et al. Partial cutting of sternothyroid muscle during total thyroidectomy: impact on postoperative vocal outcomes. Sci World J. 2013;2013:416535.
  16. Lee HS, Kim SW, Park CW, Kim CH, Kim SB, Lim SJ, et al. Risk factors of deteriorated voice quality in patients who underwent thyroidectomy. Kor J Head Neck Oncol. 2016;32:6-20.
  17. Vicente DA, Solomon NP, Avital I, Henry LR, Howard RS, Helou LB, et al. Voice outcomes after total thyroidectomy, partial thyroidectomy, or non-neck surgery using a prospective multifactorial assessment. J Am Coll Surg. 2014;219:152-163. https://doi.org/10.1016/j.jamcollsurg.2014.03.019
  18. Lang BH, Wong CK, Ma EP. A systematic review and meta-analysis on acoustic voice parameters after uncomplicated thyroidectomy. Laryngoscope. 2016;126:528-537. https://doi.org/10.1002/lary.25452
  19. Tae K, Kim KY, Yun BR, Ji YB, Park CW, Kim DS, et al. Functional voice and swallowing outcomes after robotic thyroidectomy by a gasless unilateral axillo-breast approach: comparison with open thyroidectomy. Surg Endosc. 2012;26:1871-1877. https://doi.org/10.1007/s00464-011-2116-0
  20. Dietrich M, Verdolini Abbott K, Gartner-Schmidt J, Rosen CA. The frequency of perceived stress, anxiety, and depression in patients with common pathologies affecting voice. J Voice. 2008; 22:472-488. https://doi.org/10.1016/j.jvoice.2006.08.007
  21. Marmor S, Horvath KJ, Lim KO, Misono S. Voice problems and depression among adults in the United States. Laryngoscope. 2016;126:1859-1864. https://doi.org/10.1002/lary.25819
  22. Siupsinskiene N, Adamonis K, Toohill RJ. Quality of life in laryngopharyngeal reflux patients. Laryngoscope. 2007;117:480-484. https://doi.org/10.1097/MLG.0b013e31802d83cf