Laryngeal and vocal alterations after thyroidectomy

Abstract

Vocal symptoms, reported by 27.8% of the patients on the 1st post decreased to 7% in 6 months. In the acoustic analysis, f0 and APQ were decreased. Transient paralysis of the vocal folds secondary to recurrent and superior laryngeal nerve injury occurred in, respectively, 21% and 1.3% of the patients, decreasing to 6.6% and 0% after 6 months.

Perfil Epidemiológico dos Pacientes com Câncer de Cabeça e Pescoço em um Centro Oncológico no Sul do Brasil

“…Essas alterações ocasionam, na maioria das vezes, perda de peso e desnutrição por causa das morbidades geradas pelo tratamento, provocando um enorme declínio funcional 9 . Entre as alterações e declínios funcionais causados pelos tratamentos do câncer de cabeça e pescoço, há ainda o linfedema, a síndrome do ombro caído, paralisias faciais, trismo (redução da abertura bucal) e paralisia das cordas vocais 7,11 . O câncer de cabeça e pescoço é induzido por uma combinação de fatores, inclusive pela Região 12 ; ou seja, existe uma discrepância observada nos dados epidemiológicos publicados da doença nas diversas Regiões do Brasil, podendo ser pela carência dos registros de dados 12 , demonstrando que existem poucos dados da doença na literatura e que tais valores são subestimados 13 .…”

Voice- and swallowing-related symptoms after total thyroidectomy: evidence from a Brazilian national survey

“…The most prevalent symptoms were related to voice, a result similar to other studies with people submitted to total thyroidectomy 8,9,17 . Such an occurrence may be related to the topographic nearness of the thyroid gland in relation to the laryngeal structures and peripheral innervations, which are exposed and manipulated during the surgical procedures 15 . Despite the concern with the possibility of vocal fold palsy due to iatrogenic lesion of the superior and/or inferior laryngeal nerve, most of the cases have complaints even in the absence of peripheral nervous lesions 12 .…”

“…Immediately after surgery, these proportions are even higher and may reach 69.2% and 80.8%, respectively 11 . The symptoms are possibly caused by laryngeal manipulation 12 , surgery time 8,13 , type of surgical technique used 14 , dissection of the cervical muscles 13,15 , orotracheal intubation, hematoma, stretching and fixing the cervical muscles, lesions in the superior and inferior laryngeal nerves 15 , besides the post-thyroidectomy syndrome, which occurs when there are complaints even in the absence of postoperative complications 12,16 .…”

Frequência combinada de queixas relacionadas à deglutição e voz antes da tireoidectomia

“…Benign or malignant thyroid disorders affect hormone production and secretion (1) and may alter functional patterns of voice (1)(2)(3) and swallowing (1,3,4) . Such diseases can be treated by thyroidectomy, which consists of partial or total removal of the thyroid gland (1,5,6) . This procedure can lead to voice and swallowing changes due to multiple factors such as extent of surgery (1,7) , technique used in the procedure (8,9) , orotracheal intubation (5,6) , dissection of cervical muscles (6) , bruising (6) , and manipulation of the laryngeal nerves (1,5,6,10) .…”

“…In addition, increased gland volume (1,11,12) and the presence of benign or malignant nodules (1,13,14) may cause compressive symptoms such as shortness of breath (1,13,14) , swallowing effort (1,4,14) , foreign body sensation in the throat (1,4,13,(15)(16)(17) , choking (17) , and odynophagia (1,4,13,17) , impacting the biomechanics of swallowing. Similarly, communication may be affected by vocal symptoms such as hoarseness, voice weakness, and monotonous voice (1,6,10,16) , as well as by physical symptoms such as throat clearing, pain and discomfort when speaking (18) .…”