Abstract

PurposeVoice problems are common after thyroidectomy. The aim of this study was to assess the voice related quality of life after thyroidectomy with neuromonitoring. The sociodemographic and treatment factors influencing the quality of voice after the operation were investigated.MethodsA total of 40 patients after thyroidectomy with neuromonitoring were enrolled into the study. The voice outcome was analyzed pre and postoperatively by two validated self-assessment questionnaires: Voice Handicap Index and Voice-Related Quality of Life survey.ResultsAll external branches of the superior laryngeal nerve were identified during the operation. There were no recurrent laryngeal nerve palsies. The mean total VHIs before and after thyroid operation were 1.2 [SD 2.564] and 2.8 [SD 6.944], respectively (p = 0.5). Preoperatively, the mean overall score for the V-RQOL was 99.6; postoperatively 98.7 (p = 0.05). A strong correlation between the V-score of the V-RQOL and O-score of the VHI before and after thyroidectomy was observed (both p < 0.001).There was no correlation between V-RQOL or VHI and sex, the kind of thyroid operations, diagnosis, thyroid function, the mean volume of the goitre, the presence of retrosternal position and the extent of thyroid operations (p > 0.05). A small correlation between the mean age of the patients and postoperative O-Score of the VHI (p = 0.007650) and between the mean age and postoperative V-Score for the V-RQOL (p = 0.00648) was observed.ConclusionsThe use of neuromonitoring in thyroid surgery is beneficial for patients to improve voice quality. The identification and preservation of EBSLNs is crucial to eliminate altered voice after thyroidectomy.

Highlights

  • There are many indications for surgical treatment of the thyroid gland

  • There was no correlation between Voice-Related Quality of Life (V-RQOL) or Voice Handicap Index (VHI) and sex, the kind of thyroid operations, diagnosis, thyroid function, the mean volume of the goitre, the presence of retrosternal position and the extent of thyroid operations (p > 0.05)

  • The use of neuromonitoring in thyroid surgery is beneficial for patients to improve voice quality

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Summary

Introduction

An increase in the rate of thyroid surgery has been observed. In the last three decades, the rate of thyroid operations has tripled in the United States [1]. More operations are performed due to thyroid cancer, thanks to better access to ultrasound examinations and FNAB. These examinations have increased the identification of malignancy in nodules from 15 to 50%, in small papillary cancers [2]. The extent of surgery (total vs subtotal) has been controversial until recently [3], but currently, total thyroidectomy is recommended in most high-volume thyroid surgery units [4, 5].

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