Nam Inn-Chul, Bae Ja-Seong, Lee So-Hee, Kim Jeong-Soo, Hwang Yeon-Shin, Shim Mi-Ran, Kim Geun-Jeon, Park Jun-Ook, Park Young-Hak, Sun Dong-Il
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Clin Otolaryngol. 2023 Jan;48(1):39-49. doi: 10.1111/coa.13995. Epub 2022 Oct 28.
Voice change after uncomplicated thyroidectomy has been an important issue in the field of thyroid surgery. The aim of this study was to promote understanding of voice change after uncomplicated thyroidectomy by analysing the results for a large number of patients from a single institute.
We retrospectively reviewed the medical records of 2879 consecutive patients who underwent thyroidectomy and voice evaluation between January 2014 and December 2019 in a single institute. All the patients had their vocal status assessed using videostroboscopy, acoustic voice analyses, aerodynamic study, and Thyroidectomy-related Voice and Symptom Questionnaire (TVSQ) scores preoperatively and at 1, 3, and 6 months postoperatively. We analysed the pattern of voice changes over time and differences in voice parameters based on clinical factors. To confirm the usefulness of the TVSQ, the correlation between TVSQ scores and objective parameters was analysed. Lastly, predictive factors for persistent voice symptoms were analysed.
Tertiary referral hospital.
The frequency ranges and TVSQ scores exhibited significant deterioration until 6 months following surgery. Among clinical factors, the extents of thyroidectomy and neck dissection were associated with worse voice parameters. The TVSQ score was significantly correlated with objective voice parameters. The extents of thyroidectomy and neck dissection were predictive of persistent voice symptoms at 6 months after thyroidectomy.
After uncomplicated thyroidectomy, most voice parameters tended to recover, but some parameters remained aggravated even at 6 months after surgery. With more extensive surgery, worse voice quality and the higher risk of persistent voice symptoms may be anticipated.
在甲状腺手术领域，单纯甲状腺切除术后的嗓音变化一直是一个重要问题。本研究的目的是通过分析来自单一机构的大量患者的结果，增进对单纯甲状腺切除术后嗓音变化的理解。
我们回顾性分析了2014年1月至2019年12月在单一机构接受甲状腺切除术和嗓音评估的2879例连续患者的病历。所有患者在术前以及术后1个月、3个月和6个月时，使用频闪喉镜检查、声学嗓音分析、空气动力学研究和甲状腺切除相关嗓音与症状问卷（TVSQ）评分评估其嗓音状态。我们分析了嗓音随时间变化的模式以及基于临床因素的嗓音参数差异。为了证实TVSQ的有效性，分析了TVSQ评分与客观参数之间的相关性。最后，分析了持续性嗓音症状的预测因素。
三级转诊医院。
频率范围和TVSQ评分在术后6个月内均呈现显著恶化。在临床因素中，甲状腺切除术和颈部清扫术的范围与更差的嗓音参数相关。TVSQ评分与客观嗓音参数显著相关。甲状腺切除术和颈部清扫术的范围可预测甲状腺切除术后6个月时的持续性嗓音症状。
单纯甲状腺切除术后，大多数嗓音参数倾向于恢复，但即使在术后6个月，一些参数仍持续恶化。手术范围越大，预期嗓音质量越差，持续性嗓音症状的风险越高。
