Department of Surgery, Army Audiology and Speech Center, Walter Reed Army Medical Center, Washington, District of Columbia 20307, USA.
J Voice. 2012 Jul;26(4):454-61. doi: 10.1016/j.jvoice.2011.03.010. Epub 2011 Jul 23.
OBJECTIVES/HYPOTHESES: Changes in vocal function before and after thyroidectomy were examined using aerodynamic and related assessments. Laryngeal airway resistance (R(law)) and phonation threshold pressure (PTP) were hypothesized to be sensitive to changes in laryngeal function that may occur after thyroidectomy separate from changes that may occur from endotracheal intubation alone.
Prospective longitudinal clinical trial with comparison group.
Eighty patients were evaluated preoperatively, and 2 weeks and 3 months postoperatively to assess voice outcomes after thyroidectomy. In addition, 16 patients who underwent a nonneck operation were tested as a control group. Maximum phonation time (MPT), mean airflow, R(law), and PTP were determined at two vocal fundamental frequency (F0) levels (30% and 80% of the F0 range).
No systematic differences were detected for MPT, mean airflow, or R(law) as a short-term or intermediate-term outcome of either surgical group. PTP decreased significantly over time for both groups of participants and at both F0 levels. F0 range decreased significantly at the short-term postsurgical assessment and covaried with the PTP results, thereby explaining some of the variability in the PTP data.
Aerodynamic assessment did not reveal systematic changes in vocal function associated with thyroidectomy, although PTP decreased postoperatively for both surgical groups. This may be attributable in part to a learning effect or to postoperative reductions in F0 range.
目的/假设：通过气动及相关评估检查甲状腺切除前后的嗓音功能变化。假设喉气道阻力（R(law)）和发音阈值压（PTP）对喉功能的变化敏感，这些变化可能与单独气管插管引起的变化不同，而是发生在甲状腺切除术后。
具有对照组的前瞻性纵向临床试验。
80 例患者分别在术前、术后 2 周和 3 个月进行评估，以评估甲状腺切除术后的嗓音结果。此外，还对 16 例接受非颈部手术的患者进行了测试作为对照组。在两个声门基频（F0）水平（F0 范围的 30%和 80%）下测量最大发音时间（MPT）、平均气流、R(law)和 PTP。
在短期或中期结果中，手术组患者的 MPT、平均气流或 R(law)均未显示出系统差异。两组参与者的 PTP 随时间显著降低，且在两个 F0 水平上均降低。F0 范围在术后短期评估中显著降低，与 PTP 结果相关，从而解释了 PTP 数据的一些变异性。
气动评估并未发现与甲状腺切除术相关的嗓音功能系统变化，尽管两组手术患者的 PTP 术后均降低。这部分可能归因于学习效应或术后 F0 范围的降低。
