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Updated: May 11, 2025

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Effectiveness of Perioperative Dexamethasone in Reducing Postoperative Voice Changes in Patients Undergoing
Dalia Hamdan1, Renad Alsolamy2, Atheer Altalhi3
1Otolaryngology-Head and Neck Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia.
Objectives/Hypothesis:
Postoperative voice changes is a common complication following thyroidectomy, which usually decrease patient quality of life. Perioperative dexamethasone is hypothesized to mitigate these effects by reducing inflammation and edema. However, the evidence supporting its efficacy remains inconclusive. This study aims to evaluate the effectiveness of perioperative dexamethasone in reducing postoperative voice changes in patients undergoing thyroidectomy through a systematic review and meta-analysis.
Study Design:
Systematic review and meta-analysis of randomized controlled trials.
Methods:
The current study was conducted under the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. This study systematically reviewed the MEDLINE, Cochrane, and EMBASE databases in September 2022, using keywords relevant to the study outcome.
Results:
Eight randomized controlled trials encompassing 1244 participants were included. Subjective outcomes revealed that dexamethasone significantly reduced voice dysfunction scores within the first 48 hours postoperatively (SMD: -0.55, 95% CI: -0.82 to -0.28, P < 0.001), with no significant differences observed after day 7. Objective outcomes, reported in two trials (n = 639), showed no significant improvement in fundamental voice frequency (MD: 11.18, 95% CI: -17.36 to 39.71, P = 0.44).
Conclusion:
Our meta-analysis concluded that perioperative dexamethasone significantly reduces subjective voice dysfunction in the immediate postoperative period following thyroidectomy. However, no objective improvement was observed, and its effects deplete beyond 7 days. Future studies should focus on evaluating objective measures to confirm its clinical utility.
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