갑상선 수술범위에 따른 음성의 음향적 분석

Abstract

Voice complication without the laryngeal nerve injury can occur after thyroidectomy. The purpose of this study is to investigate voice changes according to extent of thyroidectomy with acoustic analysis. Thirty-five female patients with papillary thyroid carcinoma took voice evaluation at before and 1 month, and 3 months after thyroidectomy. Acoustic analysis parameters were speaking fundamental frequency(SFF), min <TEX>$F_0$</TEX>, max <TEX>$F_0$</TEX>, dynamic range <TEX>$F_0$</TEX>, jitter, shimmer, noise-to-harmonic ratio(NHR), and Cepstral prominence peak(CPP). Repeated-measured analysis of variance was applied. Time-related voice changes showed significant differences in all parameters except NHR. At 1 month after surgery, voice quality was worse and pitch was decreasing, but voice quality and pitch were improving at 3-month follow-up. Voice changes according to the extent of surgery were in SFF, max <TEX>$F_0$</TEX>, and dynamic range <TEX>$F_0$</TEX>. Time by surgery-related voice change existed only in min <TEX>$F_0$</TEX>. The result showed that the severity of voice complication depended on the extend of thyroidectomy which had a negative impact on <TEX>$F_0$</TEX>-related parameters. The deterioration of voice quality at 1 month after thyroidectomy may be affected by the loss of thyroid hormone in the blood. The descent of <TEX>$F_0$</TEX>-related parameters may be impacted by laryngeal fixation of surgical site adhesion.