Intraoperative Corticosteroids for Voice Outcomes among Patients Undergoing Thyroidectomy: A Systematic Review and Meta‐analysis

Noel, Julia E.; Kligerman, Maxwell P.; Megwalu, Uchechukwu C.

doi:10.1177/0194599818793414

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…From this study, it was found that the effect of dexamethasone which significantly reduces the incidence of laryngeal edema. 11 In this study, the length of the operation performed did not significantly affect the final outcome of sound changes in the patient, and there were no complications such as PEAO in the patient, because the patient was relatively intubated for no more than 24 hours.…”

Section: Discussionmentioning

confidence: 57%

Intravenous Dexamethasone as Prophylaxis Against Laryngeal Edema Associated with Changes in Sound Quality in Patients Undergoing Total Thyroidectomy

Putra¹,

Abdurahman²,

Rizki³

2022

mkb

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Thyroidectomy is a relatively safe surgical procedure for thyroid gland removal with a with mortality and morbidity rates of less than 2–3%. Complication in the form of sound changes often goes unnoticed in post-thyroid patients despite its high incidence rate, i.e., 87% of all surgical cases. Laryngeal edema as the underlying cause can be triggered by intubation or extubation during anesthesia; malfunction of the strap muscles; surgery that directly causes injury to the superior laryngeal nerve; and recurrent laryngeal nerve injuries. Several studies on the use of dexamethasone to prevent or reduce laryngeal edema that occurs after thyroidectomy have been conducted with controversial results. This study was conducted to solve this controversy. This was a double-blind randomized prospective study on thyroid tumors patients who underwent thyroidectomy at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from December 2020 to May 2021. This study evaluated dexamethasone effects on the patient’s sound changes using the Sound Handicap Index (VHI) questionnaire before surgery, day 1 after the surgery, and day 7 after the surgery. Analysis showed that the VHI significantly decreased on day 1 (p<0.01) and on day 7 (p<0.01), and the difference between the VHI on day 1 (D-1) and day 7 (D-7) was significant (p<0.01). When analyzed using the bivariate analysis, no statistically significant difference was found between the VHI variable before surgery, D-1, and D-7and VHI H7 in the group of patients using dexamethasone and without dexamethasone. Dexamethasone administration has no significant effect on laryngeal edema associated with changes in sound quality.

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Section: Discussionmentioning

confidence: 57%

Intravenous Dexamethasone as Prophylaxis Against Laryngeal Edema Associated with Changes in Sound Quality in Patients Undergoing Total Thyroidectomy

Putra¹,

Abdurahman²,

Rizki³

2022

mkb

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“…Although there was no consensus regarding their effect on postoperative voice quality, however, these studies showed that steroid administration effectively reduces pain, nausea, and vomiting after surgery. The recent meta-analyses concluded that there was insufficient evidence to claim perioperative systemic steroids' effect on improving voice outcomes after thyroid surgery [89][90][91]. The EBSLN, a branch of the vagus nerve, is the motor nerve to the cricothyroid muscle, an essential tensor of the vocal folds.…”

Section: Wang Et Al Analyzed the Benefits Of Intraoperative Corticosteroids For Reducing Rln Palsymentioning

confidence: 99%

“…Despite the inconsistent findings regarding the effects of steroid treatment on postoperative voice quality, those studies showed that steroid administration effectively reduces pain, nausea, and vomiting after surgery. Recent meta-analyses concluded that there was insufficient evidence to claim that perioperative systemic steroids effectively improve voice outcomes after thyroid surgery [ 89 - 91 ].…”

Section: Plan For Release and Update Of Guidelinesmentioning

confidence: 99%

Care and Management of Voice Change in Thyroid Surgery: Korean Society of Laryngology, Phoniatrics and Logopedics Clinical Practice Guideline

Force

Ryu

Lee

et al. 2022

Clin Exp Otorhinolaryngol

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Voice change is a common complaint after thyroid surgery and has significant impacts on quality of life. The Korean Society of Laryngology, Phoniatrics, and Logopedics set up a task force team to establish guideline recommendations on education, care, and management related to thyroid surgery. The guideline recommendations include preoperative voice education, management of anticipated voice change during surgery, and comprehensive voice care after thyroid surgery, including in-depth information and up-to-date knowledge based on validated literature. The committee constructed 14 key questions (KQ) in three categories: preoperative (KQ1–2), intraoperative (KQ 3–8), and postoperative (KQ 9–14) management and developed 18 evidence-based recommendations. The Delphi survey reached an agreement on each recommendation. Detailed evidence profiles are presented for each recommendation. The level of evidence for each recommendation is classified into high, moderate, and low-quality. The recommendation

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Perioperative Use of Systemic Steroids Within Otolaryngology–Head and Neck Surgery: Evidence‐Based Guidance for Clinicians

Ikeda,

Gray,

Lee

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveTo review and synthesize the available evidence for use of perioperative systemic steroids for otolaryngologic surgical procedures.Data SourcesA comprehensive literature review with evidence‐informed recommendations.Review MethodsDatabases were queried for medical subject heading terms and keywords related to perioperative systemic corticosteroids use for comprehensive otolaryngology and subspecialty procedures including otologic, sinonasal, sleep, laryngeal, head and neck, facial plastics, and pediatric surgery. Perioperative period included preoperative (up to 7 days prior to surgery), intraoperative (on the day of surgery), and postoperative (initiated within 24 hours after surgery) timeframes.ConclusionsEvidence from clinical practice guidelines, systematic reviews, and original research studies supports perioperative systemic corticosteroid use for specific otolaryngologic indications. Numerous studies support perioperative steroid use for nausea, vomiting, or edema in tonsillectomy, rhinoplasty, and thyroidectomy, although formal guideline recommendations are limited. Strong evidence supports perioperative steroid use before and after endoscopic sinus surgery for chronic rhinosinusitis with polyposis and fungal sinusitis. Evidence of benefit is sparse or absent on systemic perioperative steroid use for the middle and inner ear, laryngeal, salivary gland surgery, and reconstructive facial plastic surgery.Implications for PracticeAlthough perioperative administration of systemic steroids is routinely performed for many otolaryngologic surgeries, high‐level evidence is limited to specific contexts. Evidence supports the benefit for reducing nausea, vomiting, or edema for several otolaryngologic procedures, as well as for either chronic rhinosinusitis with polyposis or fungal sinusitis. However, these benefits need to be weighed against risks, and further investigations are needed to define the role for perioperative steroids in otolaryngology.

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Intraoperative Corticosteroids for Voice Outcomes among Patients Undergoing Thyroidectomy: A Systematic Review and Meta‐analysis

Cited by 6 publications

References 27 publications

Intravenous Dexamethasone as Prophylaxis Against Laryngeal Edema Associated with Changes in Sound Quality in Patients Undergoing Total Thyroidectomy

Intravenous Dexamethasone as Prophylaxis Against Laryngeal Edema Associated with Changes in Sound Quality in Patients Undergoing Total Thyroidectomy

Care and Management of Voice Change in Thyroid Surgery: Korean Society of Laryngology, Phoniatrics and Logopedics Clinical Practice Guideline

Perioperative Use of Systemic Steroids Within Otolaryngology–Head and Neck Surgery: Evidence‐Based Guidance for Clinicians

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