Park Jun-Ook, Bae Ja-Sung, Lee So-Hee, Shim Mi-Ran, Hwang Yeon-Shin, Joo Young-Hoon, Park Young Hak, Sun Dong-Il
Department of Otolaryngology Head and Neck Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Department of Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
World J Surg. 2016 Oct;40(10):2382-90. doi: 10.1007/s00268-016-3511-4.
Relatively large numbers of patients complain of lower-pitched voices after thyroidectomy. However, little is known about the risk factors for, prognosis of, or progression over time of, such changes, in female patients.
We analyzed the data of 217 patients who underwent thyroid surgery and postoperative (2 weeks, and 3, 6, and 12 months after surgery) voice work-ups. To identify patients with lower-pitched voices, speaking fundamental frequencies (SFFs) were compared before and after surgery. The change was calculated for all patients (postoperative change in SFF, ΔSFF).
The mean ΔSFF was 8.35 ± 17.06 Hz and significant changes in voice pitch (ΔSFF ≥12 Hz) were evident in 93 (42.85 %) patients after surgery, mostly within 6 months, and only 18.4 % of patients had lower-pitched voices 1 year after surgery. On multivariate analysis, age (≥52 vs. <52 years) and extent of surgery remained significant predictors of lower-pitched voice after surgery. The ΔSFFs of older patients (≥52) were significantly greater than those of younger patients (<52) at the 2-week follow-up, but not at the 3-, 6-, or 12-month follow-ups. The ΔSFFs of patients who underwent total thyroidectomy were significantly higher than those who underwent lobectomy at the postoperative 2-week follow-up, but did not differ at the 3-, 6-, and 12-month follow-ups.
Patients frequently experience a lower-pitched voice after thyroid surgery. Such problems develop more frequently in the early postoperative period, in aged patients, and in those who had undergone total thyroidectomy. However, over time, the changes usually decrease to levels similar to those of patients without these risk factors.
相当多的患者在甲状腺切除术后抱怨嗓音变低沉。然而，对于女性患者中此类嗓音变化的危险因素、预后情况或随时间的进展情况，人们知之甚少。
我们分析了217例行甲状腺手术且术后（术后2周、3个月、6个月和12个月）接受嗓音检查患者的数据。为了确定嗓音变低沉的患者，比较了手术前后的言语基频（SFF）。计算所有患者的变化值（术后SFF变化值，ΔSFF）。
平均ΔSFF为8.35±17.06Hz，术后93例（42.85%）患者的嗓音音高有显著变化（ΔSFF≥12Hz），大多在6个月内，术后1年仅有18.4%的患者嗓音变低沉。多因素分析显示，年龄（≥52岁与<52岁）和手术范围仍是术后嗓音变低沉的显著预测因素。在术后2周随访时，老年患者（≥52岁）的ΔSFF明显大于年轻患者（<52岁），但在3个月、6个月和12个月随访时并非如此。在术后2周随访时，行全甲状腺切除术患者的ΔSFF明显高于行甲状腺叶切除术患者，但在3个月、6个月和12个月随访时差异无统计学意义。
患者在甲状腺切除术后经常出现嗓音变低沉的情况。此类问题在术后早期、老年患者以及行全甲状腺切除术的患者中更频繁出现。然而，随着时间推移，这些变化通常会降至与无这些危险因素患者相似的水平。
