How Can We Predict the Recovery from Pitch Lowering After Thyroidectomy?

Area of Science:

• Otolaryngology
• Speech and Voice Science
• Surgical Outcomes Research

Background:

• Thyroidectomy can lead to persistent voice pitch lowering in some patients.
• Identifying predictors of voice recovery is crucial for patient management.

Purpose of the Study:

• To identify factors predicting recovery from lowered voice pitch after thyroid surgery.
• To investigate the relationship between pre-operative and post-operative voice parameters and surgical outcomes.

Main Methods:

• Retrospective review of 133 patients undergoing total thyroidectomy for papillary carcinoma.
• Analysis of 78 patients with a voice pitch drop (>12 Hz SFF) at 2 weeks post-op.
• Comparison of videostroboscopic findings, acoustic voice data, and voice quality questionnaires.

Main Results:

• Vocal cord asymmetry at 2 weeks post-op was a strong predictor of non-recovery (OR 19.056).
• A speaking fundamental frequency (SFF) reduction >19.6 Hz at 2 weeks predicted persistent pitch lowering with 72% sensitivity and 71% specificity.
• Higher pre-operative SFF was associated with the non-recovery group.

Conclusions:

• A post-operative SFF drop >19.6 Hz is a significant predictor of persistent voice pitch lowering after thyroidectomy.
• Pre-operative SFF and early post-operative vocal cord asymmetry are also key indicators of long-term voice changes.