Kim Choung-Soo, Park Jun Ook, Bae Ja-Sung, Lee So-Hee, Joo Young-Hoon, Park Young-Hak, Hwang Yeon-Shin, Shim Mi-Ran, Sun Dong-Il
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-Daero, Seocho-Gu, Seoul, 06591, Republic of Korea.
Department of Otolaryngology Head and Neck Surgery, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea.
World J Surg. 2018 Jul;42(7):2109-2116. doi: 10.1007/s00268-017-4438-0.
Some patients complain of long-lasting voice symptoms after thyroid surgery without objective vocal fold pathology. We assessed the factors that may influence voice symptoms more than 12 months after thyroidectomy.
We performed a retrospective analysis of 68 patients from July 2010 to May 2012. The voices of all patients were analyzed before and after thyroid surgery (2 weeks and 2, 4, 6, 8, 10, and 12 months after surgery). According to the recovery of postoperative voice symptoms, patients were divided into two groups: the non-recovery group and the recovery group. Voice symptoms were measured using a thyroidectomy-related voice questionnaire (TVQ). We compared voice analysis data for each group and investigated the factors related to long-lasting postoperative voice symptoms.
Forty-nine patients were included in the recovery group, and 19 patients were included in the non-recovery group. No differences in sex ratio, tumor size, and surgical extent were found between the groups. However, the proportion of professional voice users (odds ratio 4.121; 95% confidence interval 0.983-17.267; p < 0.043) was significantly higher in the non-recovery group. The cutoff score of the TVQ, at 2 months after thyroid surgery, for the differentiation of the recovery and non-recovery groups was 25, and the sensitivity and specificity values were 84.2 and 87.8%, respectively.
Professional voice users may be presented long-lasting voice symptoms after thyroid surgery. The cutoff TVQ score of 25, at 2 months after thyroid surgery, may be a guideline for counseling patients who have voice symptoms.
一些患者在甲状腺手术后抱怨存在持续的嗓音症状，但声带无客观病理改变。我们评估了甲状腺切除术后12个月以上可能影响嗓音症状的因素。
我们对2010年7月至2012年5月的68例患者进行了回顾性分析。对所有患者在甲状腺手术前以及手术后（术后2周、2、4、6、8、10和12个月）的嗓音进行分析。根据术后嗓音症状的恢复情况，将患者分为两组：未恢复组和恢复组。使用甲状腺切除相关嗓音问卷（TVQ）测量嗓音症状。我们比较了每组的嗓音分析数据，并调查了与术后长期嗓音症状相关的因素。
恢复组纳入49例患者，未恢复组纳入19例患者。两组之间在性别比例、肿瘤大小和手术范围方面未发现差异。然而，未恢复组中职业用嗓者的比例（优势比4.121；95%置信区间0.983 - 17.267；p < 0.043）显著更高。甲状腺手术后2个月，TVQ用于区分恢复组和未恢复组的临界值为25，敏感性和特异性值分别为84.2%和87.8%。
职业用嗓者在甲状腺手术后可能出现长期嗓音症状。甲状腺手术后2个月TVQ临界值25可能作为对有嗓音症状患者进行咨询的指导标准。
