Auditory-Perceptual Voice Characteristics in Pre-Operative Patients Undergoing Thyroid or Parathyroid Surgery

Abstract

Objectives: To systematically evaluate auditory perceptual voice characteristics in people with thyroid disease prior to undergoing thyroid surgery. Patients and Methods: This study examined the auditory perceptual voice characteristics of 96 individuals with thyroid disease. Participants were categorised by type of thyroid disease (i.e. multinodular goitre, thyroid cancer, thyroid nodule, toxicity or parathyroidism) and by status of compression (i.e. compression versus no compression). Auditory perceptual voice ratings were made on samples of connected speech by using the Perceptual Voice Profile. Results: A high prevalence of participants had deviant auditory perceptual voice features; however, the majority of these abnormalities were slight to mild in severity and only 8% of participants had a clinically significant auditory perceptual abnormality. There was no significant difference in features between diagnostic categories, and only high pitch was rated as more significantly deviant in patients without compression versus those with compression. Conclusions: This study supports the need for auditory-perceptual ratings to be included as part of pre-operative multidimensional assessment of voice in patients with thyroid disease.

Qualidade de vida em voz de pacientes no pré-operatório de tireoidectomia

“…It is believed the big occurrence of voice complaint in subjects' pre thyroidectomy happens because, according to literature, regardless the thyroid disease type, it may have physiologic disturbances related to phonation system, whether in voice or breathing level [5][6][7][8][9] . Among the main voice disorders present in thyroid diseases, the most common are: decrease of loudness, vocal fatigue, decrease of fundamental frequency (especially in women), roughness, instability, and breathiness 25 . A research looking to characterize the communication disorders associated to thyroid diseases in 48 subjects, with indication of thyroid surgery in a public hospital of Curitiba city, showed the most frequent signs and symptoms were: nodule or lump in the neck (78.13%), troubles to swallow (56.25%), voice disturbances (40.63%), and breathlessness (34.38%).…”

Voice Assessment and Voice‐related Quality of Life in Patients with Benign Thyroid Disease

“…Evidence exists that thyroid hormone receptors are present in the lamina propria of the human vocal folds 1 and that the voice is therefore sensitive to disorders associated with thyroid hormone imbalances. 2,3 Thyroid disorders represent the second most common endocrine condition after diabetes mellitus. 4 This underscores the importance of studies that explore the relationship between thyroid hormone disorders and the voice.…”

“…2,11 Finally, thyroidectomy-related vocal alterations can be caused by pathophysiological or iatrogenic factors such as vocal cord palsy or paralysis, benign laryngeal diseases (ie, nodules, cysts, polyps, granulomas), or respiratory diseases, which may be present in the presurgery phase or arise postsurgically. 2,3,[12][13][14][15][16][17] Studies have shown that benign alterations of the thyroid, in addition to pathophysiological thyroid disorders, impact quality of life, often using general health tools to obtain this information. [18][19][20] These tools may be hard to interpret clinically when investigating a specific health condition such as a vocal disorder.…”

“…The hoarseness and vocal fatigue reported in hyperthyroidism could be the result of a reduction in subglottal pressure caused by respiratory muscle weakness 10 . Thyroid nodules may also cause vocal alterations, depending on their size, position, and compressive potential 2,11 . Finally, thyroidectomy‐related vocal alterations can be caused by pathophysiological or iatrogenic factors such as vocal cord palsy or paralysis, benign laryngeal diseases (ie, nodules, cysts, polyps, granulomas), or respiratory diseases, which may be present in the presurgery phase or arise postsurgically 2,3,12‐17 …”

Voice perturbations under the stress overload in young individuals: phenotyping and suboptimal health as predictors for cascading pathologies

“…These include but are not restricted to Sicca syndrome [ 10 ], dry mouth syndrome [ 11 ] and body dehydration [ 12 ], hormonal alterations linked to pubertal [ 13 ], menopausal [ 14 ] and andropausal [ 15 ] status and acromegaly [ 16 ], cardio-vocal syndrome [ 17 ], respiratory disorders (e.g. chronic obstructive pulmonary disease [ 18 ] and asthma [ 19 ]), gastrointestinal reflux [ 20 ], autoimmune diseases such as rheumatic arthritis [ 21 ] and Sjögren’s syndrome [ 22 ], systemic lupus erythematosus [ 23 ], amyloidosis [ 24 ], cystic fibrosis [ 25 ], endocrinologic disorders such thyroid dysfunction [ 26 , 27 ] and anorexia nervosa [ 28 – 30 ], underweight versus overweight and obesity [ 31 , 32 ], and diabetes [ 33 ]. Table 2 highlights corresponding laryngeal symptoms.…”