Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics (대한후두음성언어의학회지)

The Korean Society of Laryngology, Phoniatrics and Logopedics. (대한후두음성언어의학회)
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Change of Voice Parameters After Thyroidectomy Without Apparent Injury to the Recurrent Laryngeal or External Branch of Superior Laryngeal Nerve: A Prospective Cohort Study

  • Lee, Doh Young (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine) ;
  • Choe, Goun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine) ;
  • Park, Hanaro (Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Changwon Hospital) ;
  • Han, Sungjun (Department of Otorhinolaryngology-Head and Neck Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Sung Joon (Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine) ;
  • Kim, Seong Dong (Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center) ;
  • Kim, Bo Hae (Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang) ;
  • Jin, Young Ju (Department of Otorhinolaryngology-Head and Neck Surgery, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Lee, Kyu Eun (Department of Surgery, Seoul National University College of Medicine) ;
  • Park, Young Joo (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Kwon, Tack-Kyun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine)
  • Received : 2022.02.17
  • Accepted : 2022.05.17
  • Published : 2022.08.31
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Abstract

Background and Objectives The quality of life after thyroidectomy, such as voice change, is considered to be as important as control of the disease. In this study, we aimed to evaluate changes in both subjective and objective voice parameters after thyroidectomy resulting in normal morbidity of the vocal cords. Materials and Method In this prospective cohort study, 204 patients who underwent thyroidectomy with or without central neck dissection at a single referral center from Feb 2015 to Aug 2016 were enrolled. All patients underwent prospective voice evaluations including both subjective and objective assessments preoperatively and then at 2 weeks, 3, 6, and 12 months postoperatively. Temporal changes of the voice parameters were analyzed. Results Values of the subjective assessment tool worsened during the early postoperative follow-up period and did not recover to the preoperative values at 12 months postoperatively. The maximal phonation time gradually decreased, whereas most objective parameters, including maximal vocal pitch (MVP), reached preoperative values at 3-6 months postoperatively. The initial decrease in MVP was significantly greater in patients undergoing total thyroidectomy, and their MVP recovery time was faster than that of patients undergoing lobectomy (p=0.001). Patients whose external branch of the superior laryngeal nerve was confirmed intact by electroidentification showed no difference in recovery speed compared with patients without electroindentification (p=0.102), although the initial decrease in MVP was lower with electroidentification. Conclusion Subjective assessment in voice quality and maximal phonation time after thyroidectomy did not show recovery to preoperative values. Aggravation of MVP was associated with surgical extent and electroidentification.

Keywords

Acknowledgement

This study was supported by Seoul National University Hospital research fund (No. 2520-14-0130). The authors appreciate the medical research collaborating center at Seoul National University Hospital for data management.

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