Early postoperative voice-change phenotypes after thyroid surgery: a prospective cohort study.

Area of Science:

• Otolaryngology
• Speech Science
• Data Science

Background:

• Post-thyroidectomy voice change is a common complication.
• Early objective voice change patterns and their clinical relevance are not well understood.

Purpose of the Study:

• To characterize early postoperative objective voice change patterns after thyroid surgery.
• To determine the short-term clinical relevance of these voice change patterns.

Main Methods:

• A prospective cohort study included 245 patients undergoing thyroid surgery.
• Voice recordings at baseline and postoperative day 2 (POD2) were analyzed using spectral features.
• Unsupervised clustering identified three voice phenotypes (A, B, C).
• Clinical outcomes at postoperative day 7 (POD7) included Voice Handicap Index-30 (VHI-30) and Grade.

Main Results:

• Three distinct voice phenotypes (A/B/C: 59/56/130) were identified.
• Phenotypes significantly differed in VHI-30 change, VHI-30 responder rate, and Grade change at POD7 (all P < 0.001).
• Phenotype B exhibited the highest short-term burden, with a 53.6% VHI-30 responder rate, compared to 1.7% for A and 1.5% for C.

Conclusions:

• Early postoperative voice changes after thyroid surgery can be classified into clinically meaningful short-term phenotypes.
• These phenotypes correlate with patient-reported and perceptual voice outcomes.
• The identified phenotypes represent early voice change patterns, not necessarily nerve injury or long-term voice categories.