ENT Clinic, Tartu University Hospital, Tartu, Estonia.
Surgery Clinic, Tartu University Hospital, Tartu, Estonia.
Logoped Phoniatr Vocol. 2023 Oct;48(3):111-116. doi: 10.1080/14015439.2021.2020894. Epub 2021 Dec 23.
The aim of the study was to evaluate voice and swallowing function before thyroid surgery and to explore the possible role of thyroid enlargement and laryngopharyngeal reflux (LPR).
We conducted a prospective study of patients who underwent hemi- or total thyroidectomy ( = 118) and compared the results with patients of laparoscopic cholecystectomy ( = 110). All subjects underwent videolaryngostroboscopy, filled in subjective evaluations of voice, swallowing and reflux complaints. Acoustic voice analysis (AVA), maximum phonation time (MPT) and perceptual voice evaluation were conducted.
We found no difference in voice quality between study and control group, neither in subjective complaints nor in AVA or perceptual evaluation. We did find indicative signs of minor laryngeal changes in thyroid group. Swallowing Impairment Score (SIS) revealed worse swallowing function in thyroid patients ( = 0.0006). Comparison of Reflux Symptom Index (RSI) scores revealed that thyroid group patients have higher values compared to control group ( = 0.006). Nevertheless, Reflux Finding Score (RFS) showed identical scores in both groups ( = 0.220). In thyroid group there was a strong positive correlation between RSI and SIS (ρ = 0.641), but no correlation between RFS and SIS (ρ = -0.002). In addition, we found a weak positive correlation between thyroid weight and RFS (ρ = 0.379).
Changes in laryngeal area caused by thyroid disorders do not lead to subjective but indicate slight objective disturbances in voice quality. We detected a decline in swallowing quality within thyroid patients. Higher RSI scores and a positive correlation between RFS and thyroid weight, indicate a possible role of thyroid gland in LPR.
本研究旨在评估甲状腺手术前后的嗓音和吞咽功能，并探讨甲状腺肿大和喉咽反流（LPR）的可能作用。
我们对接受甲状腺半切除术或全切除术的患者（ = 118 例）进行了前瞻性研究，并将结果与腹腔镜胆囊切除术患者（ = 110 例）进行了比较。所有患者均接受频闪喉镜检查，并填写嗓音、吞咽和反流症状的主观评估。进行声学嗓音分析（AVA）、最长发声时间（MPT）和感知嗓音评估。
我们发现研究组和对照组之间的嗓音质量没有差异，无论是在主观症状还是 AVA 或感知评估方面。我们确实在甲状腺组中发现了轻微的喉部变化迹象。吞咽障碍评分（SIS）显示甲状腺患者的吞咽功能更差（ = 0.0006）。反流症状指数（RSI）评分的比较显示，甲状腺组患者的数值高于对照组（ = 0.006）。然而，反流发现评分（RFS）在两组中的评分相同（ = 0.220）。在甲状腺组中，RSI 和 SIS 之间存在强烈的正相关（ρ = 0.641），但 RFS 和 SIS 之间没有相关性（ρ = -0.002）。此外，我们发现甲状腺重量与 RFS 之间存在弱正相关（ρ = 0.379）。
甲状腺疾病引起的喉部区域变化不会导致主观症状，但会导致嗓音质量出现轻微的客观障碍。我们发现甲状腺患者的吞咽质量下降。较高的 RSI 评分以及 RFS 和甲状腺重量之间的正相关表明甲状腺可能在 LPR 中发挥作用。
