Impact of thyroidectomy without laryngeal nerve injury on vocal quality characteristics: An objective multiparameter approach

Lierde, Kristiane Van; D’haeseleer, Evelien; Wuyts, Floris L.; Baudonck, Nele; Bernaert, Lutgarde; Vermeersch, Hubert

doi:10.1002/lary.20762

Cited by 56 publications

(66 citation statements)

References 25 publications

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“…In addition, perceptual analysis by a trained Speech Language Pathologist using the GRBAS scoring system did not reveal significant abnormalities in voice quality, despite patient perceptions of dysfunction. This is in agreement with the results from several studies where jitter, shimmer, MPT, ST range, and GRBAS measures were all within the normal range; often despite patient complaints of voice abnormalities [5,6,16,17]. In addition, studies have shown that 14-75% of patients continue to complain of voice symptoms 3 months −1 year post thyroidectomy, questioning the origin of these symptoms with regards to thyroid disease [4][5][6]16].…”

Section: Discussionsupporting

confidence: 91%

“…A literature review found that the reported prevalence of compressive symptoms in pre-operative thyroidectomy patients varied widely between studies, ranging from 11-88% [1][2][3][4][5][6][7]. Unfortunately many of these studies vary with regards to the symptoms reported as well as the methods used for data collection (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Whether these symptoms are indeed secondary to thyroid pathology or are due to a different process is often unclear. A review of the literature found the reported prevalence rates of voice and swallowing symptoms in pre-operative thyroidectomy patients to vary widely between 11-88% [1][2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…Although many of these studies report an improvement or resolution of compressive symptoms following thyroidectomy, a number of patients continue to experience voice and swallowing complaints post-operatively [4][5][6][7][8]. Due to the non-specific nature of these complaints, and the possibility of other underlying etiologies, the true prevalence of voice and swallowing symptoms due to thyroid pathology remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of voice & swallowing complaints in Pre-operative thyroidectomy patients: a prospective cohort study

Holler

Anderson

2014

J Otolaryngol - Head Neck Surg

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of voice & swallowing complaints in Pre-operative thyroidectomy patients: a prospective cohort study

Holler

Anderson

2014

J Otolaryngol - Head Neck Surg

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“…Nevertheless, it is well known among thyroid surgeons that after thyroidectomy, most patients complain of some degree of mainly transient voice changes, even in the absence of laryngeal nerve injuries-postthyroidectomy syndrome. Voice changes after uncomplicated thyroidectomy have been assessed previously [5,8,10,16]. In the past, voice outcomes have relied upon perceptual judgement of voice quality and acoustic measurement of a periodicity in the speech signal.…”

Section: Discussionmentioning

confidence: 99%

Voice outcomes after thyroidectomy without superior and recurrent laryngeal nerve injury: VoiSS questionnaire and GRBAS tool assessment

Tedla

Chakrabarti

Suchánková

et al. 2016

Eur Arch Otorhinolaryngol

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Voice symptoms are frequently reported early after thyroidectomy, even in the absence of laryngeal nerves injury. We evaluated the short-term outcomes of these functional alterations. Thirty-nine patients were enrolled in a prospective observational trial, evaluating voice function before and 3 months after uncomplicated thyroidectomy, using VoiSS as assessed using a validated patient rated questionnaire; and perceptual voice analysis using GRBAS scale (Grade, Roughness, Breathiness, Asthenia, Strain). Impact of dysphonia on patient's life using VoiSS questionnaire revealed differences between pre- and postoperative assessment. There was statistically significant worsening in the impairment subgroup of VoiSS (p = 0.027). GRBAS evaluation was consistent between the three independent raters but showed differences between pre- and postoperative voice assessment. Age, TSH and a preoperative finding of laryngopharyngeal reflux significantly predicted quality of voice after thyroid surgery (all p < 0.004), as identified by the GRBAS assessment tool, but not type of surgery, gender or smoking status; although prediction of total variance in changes of voice was modest (r = 0.07). Voice changes may occur after thyroidectomy without evident laryngeal nerve injury. Patients should be made aware of possible mild changes in voice even after uncomplicated thyroid surgery and this might be considered to be part of the informed consent.

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Comparison Between Patient-Perceived Voice Changes and Quantitative Voice Measures in the First Postoperative Year After Thyroidectomy

Kletzien

Macdonald

Orne

et al. 2018

JAMA Otolaryngol Head Neck Surg

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Importance Voice changes after thyroidectomy are typically attributed to recurrent laryngeal nerve injury. However, most postoperative voice changes occur in the absence of clinically evident vocal fold paralysis. To date, no study has compared the prevalence, duration, and consequences of voice-related disability from the patient perspective with use of quantitative vocal measures. Objective To assess quality of life consequences of posthyroidectomy voice change from the perspective of patients with thyroid cancer and to compare patient-perceived voice changes with changes in quantitative vocal variables at 5 time-points in the first postoperative year. Design Prospective Mixed-methods Observational Study within a Randomized Clinical Trial (NCT02138214) Setting University of Wisconsin Hospital and Clinics Participants Forty-two patients with clinically node-negative papillary thyroid cancer without a pre-existing vocal cord paralysis were recruited and enrolled from outpatient clinics between June 6, 2014 and March 6, 2017 as part of an ongoing randomized clinical trial. Interventions Total thyroidectomy Main Outcome(s) and Measure(s) Semi-structured interviews, symptom prevalence, and instrumental voice evaluations (Laryngoscopy, Phonation Threshold Pressure, Dysphonia Severity Index, Voice Handicap Index) occurred at baseline (n=42), 2-week (n=42), 6-week (n=39), 6-month (n=35), and 1-year (n=30) postoperative time points. Results Participants had a mean age of 48 years (interquartile range, 38–58 years; age range, 22–70 years) and were mostly female (74% [31 of 42]) and of white race/ethnicity (98% [41 of 42]). Impaired communication was the primary theme derived from patient interviews from before thyroidectomy to after hyroidectomy. Voice changes were perceived by 24 participants at 2 weeks after thyroidectomy. After surgery, voice symptoms were prevalent and persisted for 50% (21 of 42) of participants out to at least 1-year of follow-up. Quantitative vocal perturbations were detected in Dysphonia Severity Index and Voice Handicap Index at the 2-week follow-up, but returned to baseline levels by the 6-week follow-up visit. Conclusions and Relevance Voice changes are common after surgery for papillary thyroid cancer and affect quality of life for many patients out to 1-year of follow-up. Directly querying patients about postoperative voice changes and questioning whether commonly-used aerodynamic and acoustic parameters detect meaningful voice are important in identifying patients whose quality of life has been affected by post-thyroidectomy dysphonia. Trial Registration NCT02138214; https://clinicaltrials.gov/ct2/show/NCT02138214

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Impact of thyroidectomy without laryngeal nerve injury on vocal quality characteristics: An objective multiparameter approach

Cited by 56 publications

References 25 publications

Prevalence of voice & swallowing complaints in Pre-operative thyroidectomy patients: a prospective cohort study

Prevalence of voice & swallowing complaints in Pre-operative thyroidectomy patients: a prospective cohort study

Voice outcomes after thyroidectomy without superior and recurrent laryngeal nerve injury: VoiSS questionnaire and GRBAS tool assessment

Comparison Between Patient-Perceived Voice Changes and Quantitative Voice Measures in the First Postoperative Year After Thyroidectomy

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