Effects on Voice Quality of Thyroidectomy: A Qualitative and Quantitative Study Using Voice Maps

Abstract

ObjectivesThis study aims to explore the effects of thyroidectomy - a surgical intervention involving the removal of the thyroid gland—on voice quality, as represented by acoustic and electroglottographic measures. Given the thyroid gland's proximity to the inferior and superior laryngeal nerves, thyroidectomy carries a potential risk of affecting vocal function. While earlier studies have documented effects on the voice range, few studies have looked at voice quality after thyroidectomy. Since voice quality effects could manifest in many ways, that a priori are unknown, we wish to apply an exploratory approach that collects many data points from several metrics. MethodsA voice-mapping analysis paradigm was applied retrospectively on a corpus of spoken and sung sentences produced by patients who had had thyroid surgery. Voice quality changes were assessed objectively for 57 patients prior to surgery and two months after surgery, by making comparative voice maps, pre- and post-intervention, of six acoustic and electroglottographic (EGG) metrics. ResultsAfter thyroidectomy, statistically significant changes consistent with a worsening of voice quality were observed in most metrics. For all individual metrics, however, the effect sizes were too small to be clinically relevant. Statistical clustering of the metrics helped to clarify the nature of these changes. While partial thyroidectomy demonstrated greater uniformity than did total thyroidectomy, the type of perioperative damage had no discernible impact on voice quality. ConclusionsChanges in voice quality after thyroidectomy were related mostly to increased phonatory instability in both the acoustic and EGG metrics. Clustered voice metrics exhibited a higher correlation to voice complaints than did individual voice metrics.