Mahmoud Nesreen Fathi, Khaled Dina Mohamed Fouad, Bakia Shaimaa Ahmed Saleh
Phoniatrics Unit-Department of ENT, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Medical Studies Department of Faculty of Postgraduate Childhood Studies, Ain Shams University, Cairo, Egypt.
J Voice. 2024 Dec 20. doi: 10.1016/j.jvoice.2024.11.045.
This study conducted a subjective 6-month follow-up to evaluate voice and swallowing changes after thyroid surgery in patients without clinical evidence of recurrent nerve injury.
In this prospective cohort study, voice and swallowing alterations were assessed in 56 adult patients who underwent thyroidectomy, compared to 59 patients with laryngeal conditions and 60 controls. Voice and swallowing changes were measured using auditory perceptual assessment, laryngoscopy, the Arabic Thyroidectomy‑related voice and symptom questionnaire (A-TVSQ), the Arabic VHI (A-VHI), and Swallowing Impairment Scores (SIS-6). For the thyroidectomy group, the A-TVSQ, A-VHI, and SIS-6 were recorded preoperatively, as well as at 2 weeks and 6 months postoperatively.
Significant differences were found in the preoperative median A-TVSQ (voice, neck, and total score), A-VHI, and SIS-6 across the three groups (P < 0.001). In the thyroidectomy group, A-TVSQ (voice, neck, and total score), A-VHI, and SIS-6 increased 2 weeks after surgery but showed significant improvement by 6 months (P < 0.001, 0.009, and <0.001, respectively). The total A-TVSQ remained significantly different across the three times. Although A-VHI scores slightly increased 2 weeks postoperatively (P = 0.741), they showed significant improvement by 6 months (P < 0.001). Risk factors for worse A-TVSQ scores at 6 months postoperative included professional status, type of surgery, and baseline questionnaire scores.
Following thyroidectomy, voice and swallowing changes are common within the first 2 weeks but improve by the 6-month period. Nearly 48% of patients experience voice and neck discomfort despite no signs of recurrent laryngeal nerve injury. The findings highlight the importance of further research into the factors contributing to these symptoms. Patients should be counseled that even in the absence vocal cord injury, voice and swallowing problems may occur post-surgery and may take time to resolve.
