A Prospective Comparative Analysis to Study the Impact on Voice Changes Following Endoscopic Thyroidectomy

Area of Science:

• Endocrinology
• Otolaryngology
• Surgical Oncology

Background:

• Endoscopic thyroidectomy offers cosmetic benefits but raises concerns about vocal cord function.
• Trans-oral endoscopic thyroidectomy vestibular approach (TOETVA) and bilateral axillobreast approach (BABA) are two endoscopic techniques.
• Assessing vocal cord function is crucial for evaluating endoscopic thyroidectomy safety.

Purpose of the Study:

• To compare vocal cord function after TOETVA versus BABA endoscopic hemithyroidectomy.
• To evaluate subjective and objective voice parameters in patients undergoing these procedures.
• To determine the safety and feasibility of endoscopic thyroidectomy regarding voice outcomes.

Main Methods:

• A prospective study randomly assigned 39 patients to TOETVA (19) or BABA (20) endoscopic hemithyroidectomy.
• Vocal cord function was assessed using the GRBAS scale and acoustic analysis (jitter, shimmer, F0, NHR, MPT).
• Assessments were conducted at baseline, postoperative day 10, and 3 months.

Main Results:

• No significant differences in GRBAS scores or acoustic parameters (mean frequency, jitter, shimmer) between TOETVA and BABA groups.
• Noise-to-harmonic ratio (NHR) and maximum phonatory time (MPT) showed transient decreases at day 10, returning to baseline by 3 months, with no inter-group differences.
• Operative parameters were comparable, with shorter operative time noted for TOETVA.

Conclusions:

• Perioperative voice parameters are comparable between TOETVA and BABA endoscopic thyroidectomy.
• Both endoscopic techniques demonstrate similar safety profiles concerning vocal cord function.
• Endoscopic hemithyroidectomy is a viable option with minimal impact on voice quality.