Section of Endocrine Surgery, Division of Surgical Oncology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA.
Harvard Medical School, Boston, MA.
Surgery. 2021 Dec;170(6):1687-1691. doi: 10.1016/j.surg.2021.04.060. Epub 2021 Jul 31.
Long-term dysphonia may persist after thyroid surgery even in the absence of overt nerve injury. Therefore, we evaluated long-term dysphonia after thyroidectomy using a validated survey.
Patients undergoing thyroidectomy at a single institution from 1990 to 2018 were surveyed via telephone to complete the Voice Handicap Index-10 Survey. Individuals with documented nerve injury were excluded.
In total, 308 patients completed the survey (mean age 51 ± 14 years, 78% female). Median time since surgery was 10.7 (interquartile range 2.3-17.5) years. The mean Voice Handicap Index-10 Survey score was 2.6 ± 5.2. Of the 113 (37%) patients who reported subjective dysphonia, the mean Voice Handicap Index-10 Survey score was 7.1 ± 6.5. Twenty-two (7.1%) patients had a Voice Handicap Index-10 Survey score above the empiric normative cutoff of 11, with a mean score of 17.6 ± 6.8. The most frequent complaints included "The clarity of my voice is unpredictable" (N = 71, 23%), "People have difficulty understanding me in a noisy room" (N = 70, 23%), and "I feel as though I have to strain to produce voice" (N = 65, 21%).
Long-term follow-up of patients after thyroidectomy suggests that more than 30% without nerve injury report dysphonia. Research to further assess the etiology and impact of these changes on quality of life is needed.
即使没有明显的神经损伤,甲状腺手术后也可能长期存在声音嘶哑。因此,我们使用经过验证的调查来评估甲状腺切除术后的长期声音嘶哑。
对 1990 年至 2018 年在一家机构接受甲状腺切除术的患者通过电话进行调查,以完成嗓音障碍指数-10 调查。排除有记录的神经损伤的患者。
共有 308 名患者完成了调查(平均年龄 51 ± 14 岁,78%为女性)。中位手术时间为 10.7 年(四分位间距 2.3-17.5 年)。嗓音障碍指数-10 调查评分的平均值为 2.6 ± 5.2。在 113 名(37%)报告主观声音嘶哑的患者中,嗓音障碍指数-10 调查评分的平均值为 7.1 ± 6.5。22 名(7.1%)患者的嗓音障碍指数-10 调查评分超过经验性正常值 11,平均得分为 17.6 ± 6.8。最常见的抱怨包括“我的声音清晰度不可预测”(N = 71,23%)、“在嘈杂的房间里,人们很难理解我”(N = 70,23%)和“我觉得我必须用力发声”(N = 65,21%)。
甲状腺切除术后对患者的长期随访表明,超过 30%没有神经损伤的患者报告声音嘶哑。需要进一步评估这些变化的病因及其对生活质量的影响的研究。