Does corticosteroid have any beneficial effect on voice change after thyroidectomy?

Area of Science:

• Otolaryngology
• Endocrinology
• Surgical Complications

Background:

• Voice alteration is a frequent complication following thyroidectomy, impacting patients' quality of life.
• Inflammation and edema at the surgical site are hypothesized to cause post-thyroidectomy voice changes.

Purpose of the Study:

• To evaluate the efficacy of a single preoperative steroid dose in mitigating voice changes after total thyroidectomy.
• To assess the impact of intravenous dexamethasone on postoperative voice impairment.

Main Methods:

• Prospective randomized clinical trial involving 64 patients undergoing total thyroidectomy.
• Patients were randomized to receive either intravenous dexamethasone or a placebo before surgery.
• Voice Impairment Score (VIS) was used for postoperative voice change evaluation.

Main Results:

• The dexamethasone group showed a significantly lower VIS (5) compared to the placebo group (13) on postoperative day one (P < 0.001).
• By postoperative day seven, the difference in VIS between groups was not statistically significant (1 vs 3; P = 0.397).
• VIS scores significantly improved from day one to day seven in both groups (P < 0.001), with no significant complications reported for dexamethasone.

Conclusions:

• Preoperative dexamethasone may be beneficial in reducing immediate postoperative voice changes after thyroidectomy.
• Further research is warranted to explore the sustained effects and optimal timing of steroid administration for voice preservation.