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Laryngeal and vocal alterations after thyroidectomy
Renata Mizusaki Iyomasa1, José Vicente Tagliarini1, Sérgio Augusto Rodrigues2
1Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP), Disciplina de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Botucatu, SP, Brazil.
Brazilian Journal of Otorhinolaryngology
|October 15, 2017
Summary
Post-thyroidectomy dysphonia significantly improves within six months, with vocal symptoms decreasing from 27.8% to 7.2%. Most vocal fold palsies, primarily due to recurrent laryngeal nerve injury, also resolve within this period.
Area of Science:
- Otolaryngology
- Endocrinology
- Speech and Language Pathology
Background:
- Dysphonia is a frequent complication following thyroidectomy.
- Understanding vocal outcomes is crucial for patient recovery and quality of life.
Purpose of the Study:
- To comprehensively analyze vocal symptoms, acoustic and perceptual voice assessments, videolaryngoscopy findings, surgical procedures, and histopathological results in patients after thyroidectomy.
- To evaluate the incidence and recovery of vocal fold paralysis post-thyroidectomy.
Main Methods:
- A prospective study involving 151 patients undergoing thyroidectomy.
- Vocal assessments (anamnesis, acoustic analysis, videolaryngoscopy) were conducted pre-operatively and at 15 days, 1 month, 3 months, and 6 months post-operatively.
- Correlation of vocal fold palsy with surgical type and histopathological findings was analyzed.
Main Results:
- Vocal symptoms decreased from 27.8% at 15 days to 7.2% at 6 months post-surgery.
- Transient vocal fold palsies occurred in 21% (recurrent laryngeal nerve) and 1.3% (superior laryngeal nerve), with rates dropping to 6.6% and 0% by 6 months, respectively.
- Histopathology revealed a higher incidence of vocal fold palsy in carcinoma cases (21/67) compared to colloid nodular goiter (13/76).
Conclusions:
- Vocal symptoms and paralysis after thyroidectomy show significant improvement within six months.
- Recurrent laryngeal nerve injury is the primary cause of transient vocal fold paralysis post-thyroidectomy.
- Early detection and monitoring of vocal changes are essential for managing post-thyroidectomy dysphonia.