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甲状腺切除术后持续两年的主观性嗓音症状

Persistent subjective voice symptoms for two years after thyroidectomy.

作者信息

Kim Geun-Jeon, Bang Jooin, Shin Hyun-Il, Kim Sang-Yeon, Bae Ja Seong, Kim Kwangsoon, Kim Jeong Soo, Hwang Yeon-Shin, Shim Mi-Ran, Sun Dong-Il

机构信息

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Republic of Korea.

Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Am J Otolaryngol. 2023 May-Jun;44(3):103820. doi: 10.1016/j.amjoto.2023.103820. Epub 2023 Mar 1.

Abstract

BACKGROUND

Voice change after thyroidectomy is an important issue in thyroid surgery. However, little is known about long-term voice outcomes after thyroidectomy. This study investigates the long-term voice outcomes of thyroidectomy up to two years after surgery. Also, we analyzed the pattern of recovery through acoustic tests over time.

METHODS

We reviewed data from 168 patients who underwent thyroidectomy between January 2020 and August 2020 at a single institution. The Thyroidectomy-related Voice and Symptom Questionnaire (TVSQ) score and acoustic voice analysis results were examined preoperatively and postoperative one, three, and six months, and one and two years after surgery. We divided patients into two groups based on the TVSQ score (≥15 or <15) at two years postoperatively. We investigated the difference of acoustic characteristics between the two groups and analyzed correlations between acoustic parameters and various clinical and surgical factors.

RESULTS

Voice parameters tended to recover, but some parameters and TVSQ scores exhibited deterioration two years after surgery. In the subgroups, among the many clinicopathologic factors examined, voice abuse history including professional voice users (p = 0.014), greater extent of thyroidectomy and neck dissection (p = 0.019, p = 0.029), and high pitch voice (F0; p = 0.005, SFF; p = 0.016) were associated with high TVSQ score at two years.

CONCLUSIONS

Patients frequently experience voice discomfort after thyroidectomy. After surgery, voice abuse history including professional voice users, greater extent of surgery, and higher pitch voice are associated with worse voice quality and increased risk of persistent voice symptoms over the long-term.

摘要

背景

甲状腺切除术后声音改变是甲状腺手术中的一个重要问题。然而,对于甲状腺切除术后的长期声音结局知之甚少。本研究调查了甲状腺切除术后长达两年的长期声音结局。此外,我们通过声学测试分析了随时间的恢复模式。

方法

我们回顾了2020年1月至2020年8月在单一机构接受甲状腺切除术的168例患者的数据。术前、术后1个月、3个月、6个月以及术后1年和2年检查甲状腺切除相关声音和症状问卷(TVSQ)评分及声学语音分析结果。我们根据术后两年的TVSQ评分(≥15或<15)将患者分为两组。我们调查了两组之间声学特征的差异,并分析了声学参数与各种临床和手术因素之间的相关性。

结果

声音参数趋于恢复,但一些参数和TVSQ评分在术后两年出现恶化。在亚组中,在所检查的众多临床病理因素中,包括职业用嗓者在内的用嗓过度史(p = 0.014)、甲状腺切除和颈部清扫范围更大(p = 0.019,p = 0.029)以及高音调嗓音(F0;p = 0.005,SFF;p = 0.016)与术后两年的高TVSQ评分相关。

结论

甲状腺切除术后患者经常出现声音不适。术后,包括职业用嗓者在内的用嗓过度史、更大的手术范围和更高的音调嗓音与长期更差的声音质量和持续声音症状风险增加相关。

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