The evaluation of the causes of subjective voice disturbances after thyroid surgery

Soylu, Lütfi; Özbaş, Serdar; Uslu, Hatim Yahya; Koçak, Savaş

doi:10.1016/j.amjsurg.2006.10.009

Cited by 107 publications

(108 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: 80%

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: 80%

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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“…46 Although the mechanism of post-thyroidectomy voice disturbances in patients with preserved nerve functions is not yet fully understood, these effects could be due to surgical trauma, laryngotracheal fixation of the prelaryngeal strap muscles, endotracheal intubation, or trauma to the arytenoids during intubation. 47 Only 1 previous study by Worni et al 29 has tested the effects of prophylactic steroid administration on vocal function after thyroidectomy; with a similar VVAS subjective voice function evaluation, they found that temporary postoperative deterioration of the voice was reduced in patients who received dexamethasone compared to the control group. In the present study, the results were different, and no benefits with regard to voice function were noted.…”

Section: Discussionmentioning

confidence: 97%

Dexamethasone prophylaxis before thyroidectomy to reduce postoperative nausea, pain, and vocal dysfunction: A randomized clinical controlled trial

et al. 2010

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“…Reduction in quality of life (QOL) after thyroid surgery is multifactorial and may include need for lifelong medication, thyroid suppression, radioactive scanning/treatment, temporary and permanent hypoparathyroidism, temporary or permanent dysphonia postoperatively, and dysphagia. [7][8][9][10][11] Voice disturbance may be identified at least temporarily in up to 80% of patients after thyroid surgery, but prevention, evaluation, and management are incompletely defined. 8 About 1 in 10 patients experience temporary laryngeal nerve injury after surgery, with longer lasting voice problems in up to 1 in 25.…”

Section: Introductionmentioning

confidence: 99%

Clinical Practice Guideline: Improving Voice Outcomes after Thyroid Surgery

Chandrasekhar

Randolph

Seidman³

et al. 2013

Otolaryngol.--head neck surg.

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Objective. Thyroidectomy may be performed for clinical indications that include malignancy, benign nodules or cysts, suspicious findings on fine needle aspiration biopsy, dysphagia from cervical esophageal compression, or dyspnea from airway compression. About 1 in 10 patients experience temporary laryngeal nerve injury after surgery, with longer lasting voice problems in up to 1 in 25. Reduced quality of life after thyroid surgery is multifactorial and may include the need for lifelong medication, thyroid suppression, radioactive scanning/treatment, temporary and permanent hypoparathyroidism, temporary or permanent dysphonia postoperatively, and dysphagia. This clinical practice guideline provides evidence-based recommendations for management of the patient's voice when undergoing thyroid surgery during the preoperative, intraoperative, and postoperative period.Purpose. The purpose of this guideline is to optimize voice outcomes for adult patients aged 18 years or older after thyroid surgery. The target audience is any clinician involved in managing such patients, which includes but may not be limited to otolaryngologists, general surgeons, endocrinologists, internists, speech-language pathologists, family physicians and other primary care providers, anesthesiologists, nurses, and others who manage patients with thyroid/voice issues. The guideline applies to any setting in which clinicians may interact with patients before, during, or after thyroid surgery. Children under age 18 years are specifically excluded from the target population; however, the panel understands that many of the findings may be applicable to this population. Also excluded are patients undergoing concurrent laryngectomy. Although this guideline is limited to thyroidectomy, some of the recommendations may extrapolate to parathyroidectomy as well.Results. The guideline development group made a strong recommendation that the surgeon should identify the recurrent laryngeal nerve(s) during thyroid surgery. The group made recommendations that the clinician or surgeon should (1) document assessment of the patient's voice once a decision has been made to proceed with thyroid surgery; (2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, if the patient's voice is impaired and a decision has been made to proceed with thyroid surgery; (3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery if the patient's voice is normal and the patient has (a) thyroid cancer with suspected extrathyroidal extension, or (b) prior neck surgery that increases the risk of laryngeal nerve injury (carotid endarterectomy, anterior approach to the cervical spine, cervical esophagectomy, and prior thyroid or parathyroid surgery), or (c) both; (4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery; (5) inform the anesthesi...

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The evaluation of the causes of subjective voice disturbances after thyroid surgery

Cited by 107 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

Dexamethasone prophylaxis before thyroidectomy to reduce postoperative nausea, pain, and vocal dysfunction: A randomized clinical controlled trial

Clinical Practice Guideline: Improving Voice Outcomes after Thyroid Surgery

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