Objective: The aim of this multicentre study was to investigate the progression of patient-reported outcomes after thyroid surgery, with emphasis on voice and swallowing difficulties.
Methods: An online platform was used to collect replies to standardised questionnaires (voice handicap index, VHI; voice related quality of life, VrQoL; EAT-10) preoperatively and at 2-6 weeks and 3-6-12 months after surgery.
Results: A total of 236 patients were recruited from five centres that contributed with median 11 cases (range 2-186 cases). Average symptoms scores showed voice changes lasting up to 3 months: VHI increased from 4115 (preop) to 4821 (6w) and returned to 4115 at 6 months. Similarly, VrQoL increased from 124 to 156 and returned to 124 (6m). Severe voice changes (VHI>60) were reported in 12% of patients preop, 22% at 2w, 18% at 6w, 13% at 3m and 7% at 12m. Only five patients with normal preoperative voice had persistent severe voice changes after 6-12 months. Those with severe voice changes at 2 w (median VHI 70.5, IQR 65-81) had significant improvement by 6 months (median VHI 54, IQR 39-65) (p<0.001). Swallowing assessment showed a median preop score 0 (IQR 0-3) increasing to median 2 (IQR 0-8) at 2 weeks and normal values afterwards.
Conclusion: The ThyVoice online platform allows assessment of patient-reported outcome measures in thyroid surgery. Voice morbidity appears to be more frequent than commonly reported and this risk should the quoted during informed consent. Swallowing difficulties are mild but significant in the first 2 weeks.