Investigation of Voice Changes After Monitored Total Thyroidectomy

Tzu-Yen Huang ； Wing-Hei Viola Yu ； Che-Wei Wu ； Feng-Yu Chiang ； Yi-Chu Lin ； Hsin-Yi Tseng ； Show-Wen Wang ； Shu-Chen Chen ； Kuan-Hui Li

《International Journal of Head and Neck Science》 4卷2期 (2020/06) Pp. 75-80

https://doi.org/10.6696/IJHNS.202006_4(2).0004

摘要

Background: Many studies have reported that voice changes can occur after thyroidectomy without recurrent laryngeal nerve (RLN) injury. There are limited studies report with external branch of superior laryngeal nerve (EBSLN) status and their voice changes for more than one year. Intraoperative neuromonitoring (IONM) helps to confirm the functional integrity of RLN and EBSLN at the end of operation. This study investigated short-term and long-term changes in voice characteristics in patients after monitored total thyroidectomy. Methods: This retrospective study analyzed 70 patients who undergoing IONM-assisted total thyroidectomy with intact RLN and EBSLN function. Objective voice analyses were performed before surgery, within 3 months after surgery, and more than one year after surgery. Voice changes were compared over time and by gender, age, and pathology results. Results: Comparing with preoperative values, maximum frequency (Fmax), pitch range, maximal phonation time, and Mean F0 were significantly (p ＜ 0.05) worse short-term after surgery, and no objective parameter significantly differs long-term after surgery. Negative changes in jitter and noise-to-harmonic ratio short-term after surgery were significantly larger in women compared to men (p = 0.002), and negative changes in Fmax long-term after surgery were significantly larger in patients with malignant pathology compared to those with benign pathology (p = 0.006). Conclusions: Among the patients have intact RLN and EBSLN function, short-term objective voice analysis results cannot predict long-term outcome, and whether they predict subjective voice outcomes requires further research. Age is not a significant factor in voice changes after thyroidectomy. Gender and pathology results may influence voice parameters after total thyroidectomy.

關鍵字

thyroidectomy ； intraoperative neuromonitoring ； objective voice analysis ； recurrent laryngeal nerve ； external branch of superior laryngeal nerve