ENT Department, Medical School, Campinas State University, Campinas, SP, Brazil.
Braz J Otorhinolaryngol. 2009 Jul-Aug;75(4):511-6. doi: 10.1016/s1808-8694(15)30489-4.
Vocal alterations after thyroidectomy are generally related to laryngeal nerve injury or laryngotracheal mobility disorders caused by postoperative fibrosis or strap muscle lesion.
this study aims to evaluate the frequency of vocal and rima glottidis disorders after thyroidectomy.
This is a prospective study based on 35 patients submitted to thyroidectomy under local anesthesia and hypnosedation. All patients underwent voice auditory perception evaluation, voice acoustic tests and videolaryngostroboscopy preoperatively, and at one week and at 30 days postoperatively. Bilateral cricothyroid muscle electromyography was performed on the thirtieth day after surgery to confirm the presence of injury in the external branch of the superior laryngeal nerve.
14.3% of the patients presented posterior glottis deviation before surgery and normal electromyography findings. Transient and permanent vocal alteration occurred in 25.7% and 14.2% of the patients respectively.
voice disorders evaluated after voice auditory perceptive evaluation and voice acoustic tests were more intense in the group with superior laryngeal nerve external branch injury than in the injury-free dysphonic patient group. Oblique glottis can be present in normal patients; however its onset after thyroidectomy is indicative of superior laryngeal nerve external branch lesion.
目的:本研究旨在评估甲状腺切除术后发生声门和声门裂紊乱的频率。
材料与方法:这是一项前瞻性研究,共纳入 35 例在局部麻醉和镇静下接受甲状腺切除术的患者。所有患者均在术前、术后 1 周和 30 天进行了语音听觉感知评估、语音声学测试和频闪喉镜检查。术后第 30 天行双侧环甲肌肌电图检查,以确认是否存在喉上神经外支损伤。
结果:术前 14.3%的患者存在后声门偏斜,肌电图正常。25.7%和 14.2%的患者分别出现暂时性和永久性嗓音改变。
结论:通过语音听觉感知评估和语音声学测试评估的嗓音障碍在喉上神经外支损伤患者中比无神经损伤的发声障碍患者更为严重。正常患者可能存在斜位声门,但甲状腺切除术后出现斜位声门提示喉上神经外支损伤。