Effect of perioperative dexamethasone on subjective voice quality after thyroidectomy: a meta-analysis and systematic review

Cheng, Shih‐Ping; Liu, Tsang-Pai; Yang, Po‐Sheng; Lee, Kuo‐Sheng; Liu, Chien‐Liang

doi:10.1007/s00423-015-1354-3

Cited by 19 publications

(20 citation statements)

References 38 publications

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“…The authors stated that no patients reported complications associated with the use of corticosteroids [ 68 ]. However, a recent meta-analysis revealed that perioperative steroid use does not appear to reduce the risk of VFP and short-term voice disturbances after thyroidectomy [ 69 ]. Given the known potential adverse effects of steroids, prospective studies examining the benefits relative to placebo are warranted.…”

Section: Guidelines For the Management Of Uvfpmentioning

confidence: 99%

Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

Force

2020

Clin Exp Otorhinolaryngol

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The Korean Society of Laryngology, Phoniatrics and Logopedics appointed a task force to establish clinical practice guidelines for the management of unilateral vocal fold paralysis (UVFP). These guidelines cover a comprehensive range of management-related factors, including the diagnosis and treatment of UVFP, and provide in-depth information based on current, up-to-date knowledge. Detailed evidence profiles are provided for each recommendation. The CORE databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers, using a predefined search strategy. When insufficient evidence existed, expert opinions and Delphi questionnaires were used to fill the evidence gap. The committee developed 16 evidence-based recommendations in six categories: initial evaluation (R1–4), spontaneous recovery (R5), medical treatment (R6), surgical treatment (R7–14), voice therapy (R15), and aspiration prevention (R16). The goal of these guidelines is to assist general otolaryngologists and speech-language pathologists who are primarily responsible for treating patients with UVFP. These guidelines are also intended to facilitate understanding of the condition among other health-care providers, including primary care physicians, nurses, and policy-makers.

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Section: Guidelines For the Management Of Uvfpmentioning

confidence: 99%

Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

Force

2020

Clin Exp Otorhinolaryngol

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“…One previous metaanalysis reported no effectiveness of single perioperative dexamethasone to improve voice quality after thyroidectomy. [ 26 ] The study included 4 individual studies using separate estimate of τ 2 for each subgroup; preoperative, day 1, day 2. However, he did not obtain the total effect size, which is showed as SMD: −0.80 [95% CI, −1.54 to −0.05] from our metaanalysis's result.…”

Section: Discussionmentioning

confidence: 99%

Effect of single-dose intravenous dexamethasone on subjective voice quality after thyroidectomy

Kim

Kwon

Lee³

et al. 2018

Medicine

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Background:Corticosteroids are widely used to treat voice change after thyroidectomy. In this study, we evaluated the effect of a single dose of intravenous dexamethasone after thyroidectomy using a metaanalysis.Methods:Relevant studies were identified by searching the following databases: Medline, Embase, and Cochrane through February 2017. We followed PRISMA guidelines. The following search terms were used: “thyroidectomy,” “voice,” “steroid.” Random-effects models were used to estimate standardized mean differences (SMDs) and 95% confidence intervals.Results:Our search yielded one retrospective cohort study involving 122 thyroidectomy patients and 3 randomized controlled studies involving 242 thyroidectomy patients. The pooled SMD for voice quality after thyroidectomy was −0.80 (P < .05). Subgroup analysis showed significant voice quality change 1 day after administration of dexamethasone.Conclusions:Single-dose intravenous dexamethasone after thyroidectomy significantly improves subjective voice quality on day 1. The effect was not different significantly after day 1.Level of evidence:Level 2a.

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“…Although there was no consensus regarding their effect on postoperative voice quality, however, these studies showed that steroid administration effectively reduces pain, nausea, and vomiting after surgery. The recent meta-analyses concluded that there was insufficient evidence to claim perioperative systemic steroids' effect on improving voice outcomes after thyroid surgery [89][90][91]. The EBSLN, a branch of the vagus nerve, is the motor nerve to the cricothyroid muscle, an essential tensor of the vocal folds.…”

Section: Wang Et Al Analyzed the Benefits Of Intraoperative Corticosteroids For Reducing Rln Palsymentioning

confidence: 99%

“…Despite the inconsistent findings regarding the effects of steroid treatment on postoperative voice quality, those studies showed that steroid administration effectively reduces pain, nausea, and vomiting after surgery. Recent meta-analyses concluded that there was insufficient evidence to claim that perioperative systemic steroids effectively improve voice outcomes after thyroid surgery [ 89 - 91 ].…”

Section: Plan For Release and Update Of Guidelinesmentioning

confidence: 99%

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

Force

Ryu

Lee

et al. 2022

Clin Exp Otorhinolaryngol

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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

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Effect of perioperative dexamethasone on subjective voice quality after thyroidectomy: a meta-analysis and systematic review

Cited by 19 publications

References 38 publications

Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

Effect of single-dose intravenous dexamethasone on subjective voice quality after thyroidectomy

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

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