Prospective Functional Voice Assessment in Patients Undergoing Thyroid Surgery

作者：Alexander Stojadinovic, Ashok R. Shaha, Robert F. Orlikoff, Aviram Nissan, Mary-Frances Kornak, Bhuvanesh Singh, Jay O. Boyle, Jatin P. Shah, Murray F. Brennan, Dennis H. Kraus · 发表于：Annals of Surgery · 年份：2002 · DOI：10.1097/00000658-200212000-00015 · 被引用次数：301 · 研究领域：Thyroid and Parathyroid Surgery、Voice and Speech Disorders、Thyroid Cancer Diagnosis and Treatment

OBJECTIVE: To analyze voice function before and after thyroidectomy for patients with normal preoperative voice using a standardized multidimensional voice assessment protocol. SUMMARY BACKGROUND DATA: The natural history of post-thyroidectomy voice disturbances for patients with preserved laryngeal nerve function has not been systematically studied and characterized with the intent of using the data for postoperative voice rehabilitation. METHODS: During a prospective single-arm study, patients with normal voice underwent functional voice testing using a standardized voice grading scale and a battery of acoustic, aerodynamic, glottographic, and videostroboscopic tests before, 1 week after, and 3 months after thyroidectomy. Differences in observed sample means were evaluated using analysis of covariance or t test; categorical data was analyzed using the Fisher exact or chi-square test. RESULTS: Fifty-four patients were enrolled; 50 and 46 were evaluable at 1 week and 3 months, respectively. No patient developed recurrent laryngeal nerve injury; one had superior laryngeal nerve injury. Fifteen (30%) patients reported early subjective voice change and seven (14%) reported late (3-month) subjective voice change. Forty-two (84%) patients had significant objective change in at least one voice parameter. Six (12%) had significant alterations in more than three voice measures, of which four (67%) were symptomatic, whereas 25% with three or fewer objective changes had symptoms. Patie...