Long-term functional voice outcomes after thyroidectomy, and effect of endotracheal intubation on voice

Sung, Eui Suk; Kim, Ki Young; Yun, Bo Ram; Song, Chang Myeon; Ji, Yong Bae; Lee, Jin Choon; Tae, Kyung

doi:10.1007/s00405-018-5145-7

Cited by 20 publications

(19 citation statements)

References 29 publications

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“…Fifth, endotracheal intubation for general anesthesia might irritate the larynx and pharynx and cause throat symptoms. However, the effect of endotracheal intubation usually resolves within one to two weeks [4]. Therefore, the effect of endotracheal intubation is limited in this study.…”

Section: Plos Onementioning

confidence: 85%

“…Hoarseness, foreign body sensation in the throat, cough, and swallowing problems are commonly presented after thyroidectomy, even in the absence of recurrent laryngeal nerve (RLN) palsy [1][2][3][4][5]. These symptoms, including voice impairment, throat symptoms, and swallowing disorder after uncomplicated thyroidectomy, are associated with post-thyroidectomy syndrome.…”

Section: Introductionmentioning

confidence: 99%

“…These symptoms, including voice impairment, throat symptoms, and swallowing disorder after uncomplicated thyroidectomy, are associated with post-thyroidectomy syndrome. Although the etiology and pathogenesis of post-thyroidectomy syndrome are not clearly defined, possible causes may include laryngotracheal fixation, the external branch of superior laryngeal nerve (EBSLN) injury, cricothyroid muscle damage, endotracheal intubation, injury to the fine anastomotic branches connecting the RLN and EBSLN, and psychotic reaction [2,[4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Aggravation of Reflux Finding Score (RFS) after thyroidectomy

et al. 2021

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Laryngopharyngeal reflux (LPR) has been suggested as a possible cause of post-thyroidectomy syndrome. However, the pathophysiology and relationship between thyroidectomy and LPR have not been well investigated. We aimed to evaluate the correlation between thyroidectomy and LPR by assessing changes in LPR-related symptoms and laryngoscopic findings before and after thyroidectomy. Ninety-five patients who underwent thyroidectomy with or without central neck dissection were included. The reflux finding score (RFS) and reflux symptom index (RSI) were investigated one day before surgery and two, four, six, and twelve months after surgery. The RFS scores increased significantly after thyroidectomy and decreased to the preoperative level 12 months after surgery. The RSI scores increased after surgery and decreased gradually by 12 months postoperatively, although it was not statistically significant. The RSI and RFS scores improved with the administration of proton pump inhibitors. In conclusion, LPR-related laryngoscopic findings were exacerbated after uncomplicated thyroidectomy. Further studies using pH-monitoring and esophageal manometry are required to investigate the possible deterioration of LPR itself and the UES pressure after thyroidectomy.

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Section: Plos Onementioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Aggravation of Reflux Finding Score (RFS) after thyroidectomy

et al. 2021

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“…After thyroid and parathyroid surgery, VFP is the main reason for further voice complications. However, transient laryngeal trauma caused by endotracheal intubation may also trigger voice changes, which usually disappear in 2 weeks (11,12). Postoperative VFP can be detected, for instance, in two ways.…”

Section: Introductionmentioning

confidence: 99%

Patient Self-Assessment and Acoustic Voice Analysis in Screening of Postoperative Vocal Fold Paresis and Paralysis

et al. 2021

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Background and Aims: The aim of this study was to evaluate the utility of two items in vocal fold paresis and paralysis screening after thyroid and parathyroid surgery: patient self-assessment of voice using the Voice Handicap Index and computer-based acoustic voice analysis using the Multi-Dimensional Voice Program. Materials and Methods: This was a prospective study of 181 patients who underwent thyroid or parathyroid surgery over a 1-year study period (2017). Preoperatively, all patients underwent laryngoscopic vocal fold inspection and acoustic voice analysis, and they completed the Voice Handicap Index questionnaire. Postoperatively, all patients underwent laryngoscopy prior to hospital discharge; 2 weeks after the surgery, they completed the Voice Handicap Index questionnaire a second time. Two weeks postoperatively, patients with vocal fold paresis or paralysis and 20 randomly selected controls without vocal fold paresis or paralysis underwent a follow-up acoustic voice analysis. Results: Fourteen patients had a new postoperative vocal fold paresis or paralysis. Postoperatively, the total Voice Handicap Index score was significantly higher (p = 0.040) and the change between preoperative and postoperative scores was greater (p = 0.028) in vocal fold paresis or paralysis patients. A total postoperative Voice Handicap Index score > 30 had 55% sensitivity, and 90% specificity, for vocal fold paresis or paralysis. In the postoperative Multi-Dimensional Voice Program analysis, vocal fold paresis or paralysis patients had significantly more jitter (p = 0.044). Postoperative jitter > 1.33 corresponded to 55% sensitivity, and 95% specificity, for vocal fold paresis or paralysis. Conclusion: In identifying postoperative vocal fold paresis or paralysis, patient self-assessment and jitter in acoustic voice analysis have high specificity but poor sensitivity. Without routine laryngoscopy, approximately half of the patients with postoperative vocal fold paresis or paralysis could be overlooked. However, if the patient has no complaints of voice disturbance 2 weeks after thyroid or parathyroid surgery, the likelihood of vocal fold paresis or paralysis is low.

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“…A study based on a large series of patients conducted by Sorensen et al reported a significant increase in jitter% and shimmer% values in the acoustic voice analysis performed 12-24 hours after surgery [6]. In another study evaluating the postoperative acoustic voice analysis of patients who underwent thyroidectomy and parathyroidectomy, patients with nerve damage and/or injury were excluded, and a significant deterioration in the F0 and shimmer% values was detected in the first 24 hours postoperatively [11]. In our study, acoustic voice analysis performed in the first 48 hours postoperatively revealed significant deteriorations in the F0, jitter%, and shimmer% values compared with those values in the preoperative period.…”

Section: Discussionmentioning

confidence: 99%

Objective and Subjective Evaluations of the Effects of Different Types of Intubation Tube Applications on Voice Performance in the Early Postoperative Period

Kayır¹,

Doğan²,

Atan³

2019

Cureus

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ObjectiveChanges in voice performance in the postoperative period due to trauma suffered during endotracheal intubation or edema occurring in the postoperative period are often observed. The present study aimed to evaluate the effects of different types of intubation tube applications on voice performance in the early postoperative period using objective and subjective voice analysis methods.Materials and MethodsA total of 88 patients who underwent endotracheal intubation either using a cuffed endotracheal (n = 44) or spiral-embedded cuffed endotracheal (n = 44) tube were included in this study. An endotracheal tube of 7.5 mm was used for female patients and that of 8 mm was used for male patients. Preoperative acoustic voice analysis was performed, and fundamental frequency (F0), jitter%, and shimmer% values were recorded. In addition, the voice handicap index-30 (VHI-30) questionnaire was completed by the patients for subjective evaluation. The same procedure was repeated in the first 48 hours postoperatively. The preoperative and postoperative data were statistically compared. In addition, the effect of the type of endotracheal intubation tube on acoustic voice analysis parameters and VHI-30 scores was statistically evaluated.ResultsIn the early postoperative period, a significant decrease in the F0 value and a significant increase in jitter% and shimmer% values were detected. The VHI-30 score was also found to be significantly higher in the early postoperative period than in the preoperative period. The effects of both the intubation tubes on voice performance were found to be similar.ConclusionObjective and subjective evaluations revealed that voice performance was declined in the early postoperative period after orotracheal intubation.

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Long-term functional voice outcomes after thyroidectomy, and effect of endotracheal intubation on voice

Cited by 20 publications

References 29 publications

Aggravation of Reflux Finding Score (RFS) after thyroidectomy

Aggravation of Reflux Finding Score (RFS) after thyroidectomy

Patient Self-Assessment and Acoustic Voice Analysis in Screening of Postoperative Vocal Fold Paresis and Paralysis

Objective and Subjective Evaluations of the Effects of Different Types of Intubation Tube Applications on Voice Performance in the Early Postoperative Period

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