Abstract
SummaryVocal alterations after thyroidectomy are generally related to laryngeal nerve injury or laryngotracheal mobility disorders caused by postoperative fibrosis or strap muscle lesion.Aimthis study aims to evaluate the frequency of vocal and rima glottidis disorders after thyroidectomy.Materials and methodThis is a prospective study based on 35 patients submitted to thyroidectomy under local anesthesia and hypnosedation. All patients underwent voice auditory perception evaluation, voice acoustic tests and videolaryngostroboscopy preoperatively, and at one week and at 30 days postoperatively. Bilateral cricothyroid muscle electromyography was performed on the thirtieth day after surgery to confirm the presence of injury in the external branch of the superior laryngeal nerve.Results14.3% of the patients presented posterior glottis deviation before surgery and normal electromyography findings. Transient and permanent vocal alteration occurred in 25.7% and 14.2% of the patients respectively.Conclusionvoice disorders evaluated after voice auditory perceptive evaluation and voice acoustic tests were more intense in the group with superior laryngeal nerve external branch injury than in the injury-free dysphonic patient group. Oblique glottis can be present in normal patients; however its onset after thyroidectomy is indicative of superior laryngeal nerve external branch lesion.
Highlights
Thyroidectomy is currently the most frequently performed endocrine procedure
Voice disorders resulting from laryngeal nerve injury secondary to thyroidectomy may significantly impair the lives of patients, more so of those who use their voices professionally
This study aims to assess the prevalence of voice and rima glottidis disorders after thyroidectomy at one week and at thirty days postoperatively
Summary
Thyroidectomy is currently the most frequently performed endocrine procedure. Surgical treatment of the diseased thyroid gland has developed quite significantly within the past years, as it has become a multidisciplinary effort. New technologies to improve hemostasis and perioperative monitoring of the laryngeal nerves have turned thyroid surgery into a safer, less fraught with complication procedure. All technological and professional progress has improved the quality of the procedures performed, resulting in fewer postoperative complications. Voice disorders resulting from laryngeal nerve injury secondary to thyroidectomy may significantly impair the lives of patients, more so of those who use their voices professionally. Injuries to the recurrent laryngeal nerve are diagnosed immediately after surgery through direct observation of paralyzed vocal folds. As many as 87% of patients may experience voice disorders immediately after surgery diagnosed through voice auditory perception evaluation and voice acoustic tests, even in patients with uninjured recurrent laryngeal nerve[4]. It is important to assess vocal and laryngeal condition after thyroidectomy under local anesthesia and hypnosedation in order to test vocal control perioperatively through phonation during manipulation of the laryngeal nerves
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