Voice change following thyroid and parathyroid surgery.

Area of Science:

• Otolaryngology
• Neurology
• Speech-Language Pathology

Background:

• Voice complications after thyroid and parathyroid surgery are recognized but poorly understood.
• Previous studies lack comprehensive data on the nature, severity, and duration of voice changes.
• Emphasis has often been solely on recurrent laryngeal nerve (RLN) paralysis, neglecting subtle voice disorders.

Purpose of the Study:

• To prospectively assess voice changes following thyroid and parathyroid surgery using multidimensional outcome measures.
• To investigate the incidence, severity, and duration of voice alterations and their relationship to nerve function.
• To explore potential improvements in vocal function post-surgery and the implications of pre-existing nerve conditions.

Main Methods:

• Prospective study of 67 participants undergoing thyroid or parathyroid surgery.
• Utilized multidimensional voice outcome measures with strict exclusion criteria.
• Assessed participants preoperatively and at least twice postoperatively, including videostroboscopic evaluation.

Main Results:

• Overall incidence of voice complications was 0% based on patient performance and expert ratings.
• Mild early postoperative voice changes resolved by 3 months in all cases.
• Videostroboscopy showed 6 patients with improved vocal function, 15 with neurological signs, and 5 permanent RLN paralyses at 12 months.

Conclusions:

• Thyroid and parathyroid surgery has a low incidence of permanent voice complications.
• Voice quality may improve post-surgery, a finding not previously reported.
• Nerve damage does not always correlate with dysphonia, and preoperative nerve conditions may exist, impacting surgical risk and consent.