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Related Concept Videos

The Thyroid Gland01:23

The Thyroid Gland

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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Larynx01:21

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The human larynx, often referred to as the voice box, is an intricate organ located in the neck. It serves as a pathway for air to enter the lungs during respiration and is an essential component of voice production.
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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
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Updated: Feb 18, 2026

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Long-term voice quality outcomes after total thyroidectomy: a prospective multicenter study.

Frédéric Borel1, Niki Christou2, Olivier Marret3

  • 1Clinique de Chirurgie Digestive et Endocrinienne, Hôtel Dieu, CHU de Nantes, Nantes, France.

Surgery
|November 23, 2017
PubMed
Summary

Voice disorders after total thyroidectomy without vocal cord palsy are common initially but typically resolve within six months. Most patients regain preoperative voice quality, with persistent issues in less than 6%.

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Area of Science:

  • Otolaryngology
  • Endocrine Surgery
  • Quality of Life Research

Background:

  • Voice disorders are a frequent complication after thyroidectomy, even without recurrent laryngeal nerve injury.
  • Assessing long-term voice quality outcomes is crucial for patient well-being post-thyroidectomy.
  • The Voice Handicap Index (VHI) is a valuable self-assessment tool for voice quality.

Purpose of the Study:

  • To evaluate long-term voice quality outcomes in patients undergoing total thyroidectomy without vocal cord palsy.
  • To determine the incidence and duration of voice impairment following total thyroidectomy.
  • To assess the recovery trajectory of voice quality using the Voice Handicap Index self-questionnaire.

Main Methods:

  • An observational prospective multicenter study included 203 patients undergoing total thyroidectomy.
  • Patients with confirmed malignant disease, age <18, or preoperative vocal cord palsy were excluded.
  • Voice Handicap Index scores were compared preoperatively and at 2 and 6 months post-surgery, with laryngoscopy to confirm vocal cord palsy.

Main Results:

  • 176 patients without vocal cord palsy were analyzed.
  • Voice Handicap Index scores were significantly worse at 2 months post-surgery (14.41 ± 19.44) compared to preoperative values (7.02 ± 11.56; P<.0001).
  • At 6 months, VHI scores returned to preoperative levels (7.61 ± 14.02; P=.381), with only 5.7% experiencing significant voice impairment.

Conclusions:

  • Initial voice impairment occurs in approximately 20% of patients two months after total thyroidectomy without vocal cord palsy.
  • Voice quality progressively recovers to preoperative levels by six months post-surgery.
  • Persistent voice complaints are infrequent, affecting less than 6% of patients at six months post-thyroidectomy.