Voice outcomes after total thyroidectomy, partial thyroidectomy, or non-neck surgery using a prospective...

Area of Science:

• Otolaryngology
• Thyroid Surgery Outcomes
• Voice Science

Background:

• Voice alteration is a common complication following thyroid surgery.
• Comparing voice outcomes across different thyroidectomy extents is crucial for patient care.
• A multifactorial classification tool aids in objective voice assessment.

Purpose of the Study:

• To compare voice outcomes after total thyroidectomy (TT), partial thyroidectomy (PT), and non-neck (NN) surgery.
• To identify predictors of negative voice outcomes (NegVO) post-thyroidectomy.
• To evaluate the impact of surgical extent on early and late voice function.

Main Methods:

• Prospective observational study of 112 patients with normal preoperative voice.
• Serial voice evaluations using multimodality assessment at baseline and 2 weeks, 3 months, and 6 months postoperatively.
• Categorization of adverse voice outcomes into objective and subjective negative voice outcomes (NegVO).

Main Results:

• Negative voice outcomes (NegVO) occurred in 46% of TT patients and 14% of PT patients; none in NN surgery.
• Early NegVO was significantly more frequent after TT compared to NN or PT (p < 0.001).
• Most voice disturbances resolved by 6 months, with no significant difference in late NegVO among groups; Black race and early voice changes predicted late NegVO.

Conclusions:

• The extent of thyroidectomy significantly influences early postoperative voice outcomes.
• Risk factors for late NegVO were identified, suggesting a need for early voice rehabilitation referral for at-risk post-thyroidectomy patients.