Prevalence and Predictors of Post‐Thyroidectomy Voice Dysfunction in a Nigerian Cohort

Abstract

Background Advances in surgical techniques have significantly improved the safety of thyroidectomy. Quality of life issues, such as voice changes, however continue to be important considerations. This study evaluated the prevalence and determinants of voice changes following thyroidectomies for non‐malignant goiters in a Nigerian Hospital. Methodology Consecutive adults who had thyroidectomy for non‐malignant goiters were evaluated. Preoperatively, each participant had laryngoscopy and voice assessment using the Voice Handicap Index‐10. At surgery, the intubation difficulty score, size of endotracheal tubes, and duration of operation were recorded. Laryngoscopy and VHI‐10 assessments were repeated 1 week, 1 month, and 3 months after surgery. Pre and postoperative assessments were compared. Result Fifty‐four patients completed the study. Subtotal thyroidectomy was the commonest operation performed in 17 patients (31.48%), with 14 (25.93%) having total thyroidectomy. Baseline median VHI‐10 score was 6.5(IQR‐10). Five patients had abnormal preoperative laryngoscopy findings (benign vocal cord lesions). Postoperatively, seven patients had endoscopic evidence of vocal cord paralysis, six were unilateral while one was bilateral. Ten patients (18.5%) had early voice changes. Median VHI‐10 score at one week was significantly higher than baseline (10 vs. 6.5, p = 0.01). At 3 months, VHI‐10 reverted back to baseline in five of the ten patients while five patients (9.3%) had persistent voice changes. Abnormal endoscopic findings predicted the occurrence of early postoperative voice changes. Conclusion Thyroidectomy for non‐malignant goiters is associated with transient voice changes, many of which revert to normal over time. Abnormal endoscopic findings predict its occurrence.

Advances in the assessment of cosmetic outcomes, sensory alteration in surgical areas, and health-related quality of life of endoscopic thyroidectomy

“…To streamline the assessment process without compromising validity, Rosen et al introduced the VHI-10, consisting of 10 items [ 51 ]. The primary function of the VHI is to gauge the mental, physical, and social impact on patients resulting from voice alterations [ 52 – 55 ].…”

“…Notably, the median VHI-10 score was significantly higher 1 week after surgery compared to baseline. However, at the 3-month mark, the VHI-10 scores of five patients had regressed to baseline levels [ 52 ]. In another study by Han and colleagues, the VHI-10 scores of patients who underwent transoral and open thyroidectomy were compared.…”