Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Ann Surg Oncol. 2012 Sep;19(9):2963-70. doi: 10.1245/s10434-012-2253-2. Epub 2012 Apr 26.
To use objective and subjective voice function analysis to compare outcomes in patients who had undergone conventional open thyroidectomy or robotic thyroidectomy.
The study involved 88 consecutive patients who underwent thyroid surgery between May 2009 and December 2009; 46 patients underwent a conventional open thyroidectomy, and 42 underwent a robotic thyroidectomy. Auditory perceptual evaluation was used to make subjective assessments of voice function, and videolaryngostroboscopy, acoustic voice analysis with aerodynamic study, electroglottography, and voice range profile were used to make objective assessments. Each assessment was made before surgery, and at 1 week and 3 months after surgery.
The conventional open and robotic thyroidectomy groups were similar in terms of age, gender ratio, and disease profile. We found that 18 (20.5%) of the 88 patients showed some level of voice dysfunction at 1 week after surgery; that the dysfunction resolved by 3 months after surgery in all cases; and that it was not permanent according to postoperative videolaryngostroboscopy. The conventional open and robotic thyroidectomy groups were found to have similar levels of dysfunction at 1 week after surgery, except for jitter, which was greater in the robotic group. For both groups, any such dysfunction spontaneously resolved by 3 months after surgery, and there were no significant differences between the groups in terms of any voice function parameter.
Voice dysfunction was present after both open and robotic thyroidectomy (without any evident laryngeal nerve injury). However, function subsequently normalized to preoperative levels at 3 months after surgery in both groups. Voice function outcomes after robotic thyroidectomy are similar to those after conventional open thyroidectomy.
使用客观和主观的嗓音功能分析来比较接受传统开放甲状腺切除术或机器人甲状腺切除术的患者的结果。
本研究纳入了 2009 年 5 月至 2009 年 12 月期间接受甲状腺手术的 88 例连续患者；其中 46 例接受了传统开放甲状腺切除术，42 例接受了机器人甲状腺切除术。使用听觉感知评估进行嗓音功能的主观评估，使用频闪喉镜、声学分折与气流研究、声门图和嗓音范围图进行客观评估。每个评估在手术前、手术后 1 周和 3 个月进行。
传统开放甲状腺切除术组和机器人甲状腺切除术组在年龄、性别比例和疾病谱方面相似。我们发现，88 例患者中有 18 例（20.5%）在手术后 1 周时表现出某种程度的嗓音功能障碍；所有患者在手术后 3 个月时功能障碍均得到缓解，根据术后频闪喉镜检查，该功能障碍并非永久性的。在手术后 1 周时，传统开放甲状腺切除术组和机器人甲状腺切除术组的功能障碍程度相似，除了机器人组的颤噪较大。对于两组患者，任何这种功能障碍在手术后 3 个月时均自发缓解，两组之间的任何嗓音功能参数均无显著差异。
在开放和机器人甲状腺切除术后均存在嗓音功能障碍（没有明显的喉返神经损伤）。然而，两组患者在手术后 3 个月时功能均恢复到术前水平。机器人甲状腺切除术的嗓音功能结果与传统开放甲状腺切除术相似。
