Care and Management of Voice Change in Thyroid Surgery: Korean Society of Laryngology, Phoniatrics and Logopedics Clinical Practice Guideline

Abstract

Voice change is a common complaint after thyroid surgery and has significant impacts on quality of life. The Korean Society of Laryngology, Phoniatrics, and Logopedics set up a task force team to establish guideline recommendations on education, care, and management related to thyroid surgery. The guideline recommendations include preoperative voice education, management of anticipated voice change during surgery, and comprehensive voice care after thyroid surgery, including in-depth information and up-to-date knowledge based on validated literature. The committee constructed 14 key questions (KQ) in three categories: preoperative (KQ1–2), intraoperative (KQ 3–8), and postoperative (KQ 9–14) management and developed 18 evidence-based recommendations. The Delphi survey reached an agreement on each recommendation. Detailed evidence profiles are presented for each recommendation. The level of evidence for each recommendation is classified into high, moderate, and low-quality. The recommendation

Role of Prehabilitation and Rehabilitation on Functional Recovery and Quality of Life in Thyroid Cancer Patients: A Comprehensive Review

“…Surgical interventions, radiation therapy, and other treatment modalities may affect vocal cord function, resulting in changes in voice quality, pitch, loudness, and overall voice production [ 74 , 75 ]. Voice rehabilitation strategies, such as voice therapy and vocal exercises, play a crucial role in addressing dysphonia and improving vocal function in thyroid cancer survivors [ 76 ]. Figure 4 shows the potential rehabilitation strategies for the management of dysphonia in thyroid cancer survivors.…”

“…A trained speech–language therapist can guide individuals through different voice exercises and techniques to optimize vocal cord coordination, breath support, and resonance [ 78 ]. Moreover, speech–language therapists can perform vocal hygiene education and counseling for voice changes due to laryngeal physiology changes and surgical adhesions [ 76 ]. Similarly, laryngeal massage techniques might be effectively performed from the surgical site towards the surgical area in order to reduce tensions and improve vocal function [ 79 ].…”

“…Different studies have shown positive outcomes, including improvement in vocal cord function, vocal quality, and reduced voice-related distress, despite only moderate-quality evidence supporting voice therapy after thyroid surgery [ 76 ].…”

“…Lastly, educational therapy, including the maintenance of proper hydration and avoiding smoking and alcohol consumption, is a core component of a comprehensive rehabilitation approach to dysphonia [ 76 ], and avoiding throat clearing, shouting, and whispering are useful pieces of advice in the early phases after thyroid surgery [ 76 ].…”

“…Different studies have shown positive outcomes, including improvement in vocal cord function, vocal quality, and reduced voice-related distress, despite only moderatequality evidence supporting voice therapy after thyroid surgery [76]. In particular, voice therapy is a specialized form of rehabilitation that focuses on improving vocal function and is mainly used for dysphonia treatment [77].…”