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Updated: Jul 21, 2026
05:12
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Post-thyroidectomy superior laryngeal nerve injury
P Aluffi1, M Policarpo, C Cherovac
1Department of Otorhinolaryngology, University of Piemonte Orientale, Novara, Italy.
Summary
Thyroid surgery can cause voice problems due to nerve damage or muscle issues. Laryngeal videostroboscopy and spectrographic analysis effectively assess voice changes, guiding rehabilitation for professional voice users.
Area of Science:
- Otolaryngology
- Speech-Language Pathology
- Endocrinology
Background:
- Thyroidectomy can lead to voice dysfunction from laryngeal nerve damage or impaired laryngo-tracheal movement.
- External branch of the superior laryngeal nerve (EBSLN) injury is clinically challenging to detect, with electromyographic incidence varying widely (0-58%).
Purpose of the Study:
- To evaluate voice dysfunction 12-18 months post-thyroidectomy.
- To assess the utility of laryngeal videostroboscopy and spectrographic analysis in identifying voice problems.
- To correlate objective findings with subjective patient-reported symptoms.
Main Methods:
- 45 patients underwent subjective interviews, laryngeal videostroboscopy, and spectrographic analysis (fundamental frequency, jitter, shimmer, NHR).
- Laryngeal electromyography (LEMG) of cricothyroid muscles was performed in 21 patients with voice complaints.
- Vocal parameters were analyzed pre- and post-operatively in patients with and without neural damage.
Main Results:
- 14% of patients with voice problems showed unilateral EBSLN injury on LEMG.
- Voice fatigue and decreased pitch range were common symptoms.
- Acoustic analysis revealed altered patterns in some patients without objective EBSLN damage, suggesting extralaryngeal causes like laryngo-tracheal fixation.
Conclusions:
- Laryngeal videostroboscopy and spectrographic analysis are valuable tools for assessing post-thyroidectomy voice issues.
- These methods are useful even in patients without proven neural lesions.
- Early speech rehabilitation is recommended, particularly for professional voice users.
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