Šimić Prgomet Ivana, Frkanec Stjepan, Gugić Radojković Ika, Prgomet Drago
Phoniatric Center, Department of ENT and Head and Neck Surgery, University Hospital Center Zagreb, 10000 Zagreb, Croatia.
Department of ENT and Head and Neck Surgery, University Hospital Center Zagreb, 10000 Zagreb, Croatia.
Diagnostics (Basel). 2024 Dec 27;15(1):37. doi: 10.3390/diagnostics15010037.
: Thyroidectomy, a surgical procedure for thyroid disorders, is associated with postoperative voice changes, even in cases without recurrent laryngeal nerve (RLN) injury. Our study evaluates the prevalence and predictors of voice disorders in thyroidectomy patients without RLN injury. : Our single-center prospective study at the University Hospital Center Zagreb included 243 patients, with pre- and postoperative voice evaluations using acoustic analysis and videostroboscopy. Logistic regression, chi-square, MANOVA, and non-parametric tests assessed the impact of surgical, sociodemographic, and lifestyle factors. : The study analyzed 243 participants (141 lobectomy, 102 total thyroidectomy). Postoperative voice disorders occurred in 200 patients (100 lobectomy, 100 total thyroidectomy); 43 (17.7%) experienced no voice disorders. Significant associations were observed for surgery type (χ = 29.88, < 0.001), with total thyroidectomy having higher risk, surgery duration (χ = 16.40, < 0.001), thyroid volume (χ = 4.24, = 0.045), and BMI (χ = 8.97, = 0.011). Gender and age showed no significant correlation. Acoustic parameters differed significantly, with lobectomy patients showing better intensity, jitter, and shimmer values across postoperative measurements. Logistic regression identified surgery type (Exp(B) = 16.533, = 0.001) and thyroid volume (Exp(B) = 2.335, = 0.023) as predictors of voice disorders, achieving 82.7% classification accuracy. Multivariate analysis confirmed gender and surgery duration as significant contributors. Surgery duration exceeding 90 min and enlarged thyroid volume negatively influenced outcomes. Significant acoustic differences were also linked to BMI categories, with obese participants exhibiting poorer parameters, particularly shimmer and jitter. : Surgery type, thyroid volume, BMI, and surgery duration are most likely significant predictors of postoperative voice disorders.
甲状腺切除术是一种针对甲状腺疾病的外科手术，即使在没有喉返神经（RLN）损伤的情况下，也与术后声音变化有关。我们的研究评估了无RLN损伤的甲状腺切除患者声音障碍的患病率及预测因素。：我们在萨格勒布大学医院中心进行的单中心前瞻性研究纳入了243例患者，术前和术后使用声学分析和视频频闪喉镜对声音进行评估。逻辑回归、卡方检验、多变量方差分析和非参数检验评估了手术、社会人口统计学和生活方式因素的影响。：该研究分析了243名参与者（141例行叶切除术，102例行全甲状腺切除术）。200例患者出现术后声音障碍（100例行叶切除术，100例行全甲状腺切除术）；43例（17.7%）未出现声音障碍。观察到手术类型（χ = 29.88，P < 0.001）、全甲状腺切除术风险更高、手术持续时间（χ = 16.40，P < 0.001）、甲状腺体积（χ = 4.24，P = 0.045）和体重指数（χ = 8.97，P = 0.011）之间存在显著关联。性别和年龄无显著相关性。声学参数有显著差异，叶切除术患者在术后测量中强度、抖动和闪烁值更好。逻辑回归确定手术类型（Exp(B) = 16.533，P = 0.001）和甲状腺体积（Exp(B) = 2.335，P = 0.023）为声音障碍的预测因素，分类准确率达82.7%。多变量分析证实性别和手术持续时间为重要影响因素。手术持续时间超过90分钟和甲状腺体积增大对结果有负面影响。显著的声学差异也与体重指数类别有关，肥胖参与者的参数较差，尤其是闪烁和抖动。：手术类型、甲状腺体积、体重指数和手术持续时间很可能是术后声音障碍的重要预测因素。
