Assessment of Voice Changes of Patients after Thyroidectomy Without Inferior and Superior Laryngeal Nerves Injury According to the Intraoperative Neuromonitoring

Abstract

Objectives: to assess voice changes of patients after thyroidectomy without inferior and superior laryngeal nerves injury according to the intraoperative neuromonitoring. Material and methods: This monocentric study included all patients who underwent thyroidectomy with laryngeal nerves neuromonitoring between September, 2018 and December, 2019. The voice assessment was performed 1 month before and 3 months after surgery. It was both subjective (with Voice Handicap Index 10 and GRBAS scale) and objective (Dysphonia Severity Index). Voice was considered impaired if there was an increase ≥ 4 points of the Voice Handicap Index 10 score or ≥ 1 point of the GRBAS scale score or a decrease ≥ 2 points of the Dysphonia Severity Index score between the two vocal assessments. A composite score was created, combining both subjective and objective scores. Predictive factors of altered voice were seek. Results: Fifty-nine patients were analyzed. Mean Voice Handicap Index 10 varied from 3.39 ± 5.40 to 2.90 ± 5.29 (p = 0.62) before and after the surgery respectively, mean GRBAS from 0.64 ± 0.76 to 0.73 ± 0.85 (p = 0.57) and mean Dysphonia Severity Index from 8.47 ± 1.15 to 8.31 ± 1.03 (p = 0.42). Voice impairment composite score identified 14 patients with an impaired voice (23.7%). Age ≥65 years, preoperative Voice Handicap Index 10 score ≥ 3 and thyroidectomy past history were independent risk factors of voice impairment. Conclusions: the voice quality 3 months after thyroidectomy was not significantly subjectively and objectively changed compared to before thyroidectomy. When grouping voice impairment scores, age ≥65 years, preoperative Voice Handicap Index 10 score ≥ 3 and thyroidectomy past history were independent risk factors of voice impairment.