Voice Changes after Late Recurrent Laryngeal Nerve Identification Thyroidectomy.

Area of Science:

• Otolaryngology
• Endocrine Surgery
• Vocal Cord Function

Background:

• Thyroidectomy carries risks of recurrent laryngeal nerve (RLN) injury, potentially causing voice changes.
• The late RLN identification technique aims to minimize operative trauma during thyroid dissection.

Purpose of the Study:

• To evaluate voice alterations in patients undergoing thyroidectomy with a late recurrent laryngeal nerve (RLN) identification technique, specifically when the nerve was not injured.
• To compare voice outcomes between hemithyroidectomy and total thyroidectomy subgroups and a control group.

Main Methods:

• A prospective study involving 64 patients undergoing thyroidectomy with late RLN identification.
• Voice assessment using a standardized protocol and Voice Problem Self-Assessment Scale at multiple postoperative intervals (1 week, 3 months, 6 months).
• Comparison with a control group of 20 patients who underwent other extracervical surgeries.

Main Results:

• Temporary dysphonia and acoustic deviations (fundamental frequency, noise-to-harmonic ratio, maximal phonation time) were observed at 1 week post-surgery.
• These voice changes significantly improved by 3 months and were non-significant by 6 months post-surgery.
• Patient-reported voice problems also showed significant worsening only at 1 week post-surgery, returning to baseline later.

Conclusions:

• Thyroidectomy employing a late RLN identification technique, without nerve injury, leads to transient and mild voice changes.
• These voice changes are comparable to those seen after other non-neck surgeries.
• The late RLN identification method is a voice-sparing approach in thyroid surgery.