Early Assessment of Voice Problems in Post-Thyroidectomy Syndrome Using Cepstral Analysis

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Acoustic Analysis

Background:

• Post-thyroidectomy syndrome (PTS) presents voice issues despite the absence of recurrent laryngeal nerve injury.
• Understanding the subjective and objective voice alterations in PTS is crucial for patient management.

Purpose of the Study:

• To investigate voice changes in patients with PTS using subjective and objective measures.
• To evaluate the efficacy of the Voice Fatigue Index (VFI) and cepstral analysis in assessing PTS-related voice dysfunction.

Main Methods:

• Retrospective analysis of 96 patients undergoing thyroidectomy without nerve injury.
• Pre- and post-operative voice assessments including Voice Handicap Index (VHI), VFI, auditory perceptual, acoustic (cepstral analysis), aerodynamic, and glottal vibration analyses.
• Focus on female patients to analyze changes in VHI, VFI, cepstral peak prominence (CPP), and maximum fundamental frequency (F0max).

Main Results:

• In females, VHI and VFI significantly increased post-thyroidectomy, correlating with each other.
• Cepstral analysis revealed a decrease in CPP for vowels and sentences in females, correlating with VHI and VFI.
• A significant decrease in maximum fundamental frequency (F0max) was observed, correlating with subjective voice assessment changes.

Conclusions:

• The VFI is an effective tool for subjective voice evaluation in PTS, comparable to the VHI.
• Cepstral analysis, particularly CPP, shows potential as an objective index reflecting subjective voice discomfort in PTS.
• These findings suggest cepstral analysis could be a valuable component of comprehensive PTS voice evaluation.