Therapeutic Approach to Patients With a Lower‐Pitched Voice After Thyroidectomy

Nam, Inn‐Chul; Bae, Ja-Sung; Chae, Byung Joo; Shim, Mi‐Ran; Hwang, You Mi; Sun, Dong‐Il

doi:10.1007/s00268-013-2062-1

Cited by 16 publications

(19 citation statements)

References 31 publications

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“…Although deterioration in other acoustic parameters was also observed, the differences were not statistically significant. A previous study by the current authors found that patients who underwent thyroidectomy without laryngeal nerve injury also had lower-pitched voices 7 . However, the current study revealed greater decreases in fundamental frequency and speaking fundamental frequency after thyroidectomy with lateral neck dissection.…”

Section: Discussioncontrasting

confidence: 70%

Lateral neck dissection affects the voice in thyroid cancer patients

Nam

et al. 2017

J. Laryngol. Otol.

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Section: Discussioncontrasting

confidence: 70%

Lateral neck dissection affects the voice in thyroid cancer patients

Nam

et al. 2017

J. Laryngol. Otol.

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“…High pitch tended to decrease in the transoral group, but statistical significance was not attained. Approximately 15% of patients exhibited clinically significant lower-pitched voices (ΔSFF > 12 Hz) one month after TOETVA, similar to the proportion exhibiting lower-pitched voices after open thyroidectomy (seen in this study and our previous reports) [ 12 , 13 ]. Our results suggest that TOETVA does not impose any additional pitch risk to those imposed by conventional open surgery.…”

Section: Discussionsupporting

confidence: 89%

“…Changes in all patients were calculated (postoperative change in SFF, ΔSFF = preoperative value of SFF – postoperative value of SFF, Hz). If the ΔSFF was > 12 Hz, the patient was considered to have a lower-pitched voice [ 12 , 13 , 21 ]. The software defines jitter values up to N < 1.1% and shimmer values up to N < 3.8% as normal.…”

Section: Methodsmentioning

confidence: 99%

“…However, many patients suffer from minor voice problems after surgery, including frequent vocal fatigue and/or an inability to form high-pitched sounds and sing, even in the absence of recurrent laryngeal nerve injury and visible vocal cord paralysis [ 6 , 7 , 8 , 9 ]. Postoperative lowering of voice pitch is rather common (18% of patients) [ 10 , 11 , 12 , 13 ]. Several hypotheses have been proposed, such as inadvertent damage to the external branch of the superior laryngeal nerve (EBSLN) during surgery, postoperative adhesion of the strap muscle, changes in the laryngeal mucosa after thyroidectomy, and damage to the vocal cords caused by orotracheal intubation during surgery [ 8 , 9 , 10 , 11 , 13 , 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Can Voice Pitch Be Preserved in Patients after Transoral Endoscopic Thyroidectomy Vestibular Approach?

Kim

Park

et al. 2020

JCM

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Introduction: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has become increasingly popular. Several reports have emphasized the safety and efficacy of this new approach. However, there is no report on functional voice outcomes, including voice pitch change after TOETVA. Methods: The functional voice outcomes of patients undergoing TOETVA were compared with those of patients undergoing conventional thyroidectomy. A total of 82 consecutive patients were included in the study: 44 underwent thyroid lobectomy via TOETVA (transoral group) and 38 underwent thyroid lobectomy via the classic cervical approach (open group). Thyroidectomy-related voice questionnaire (TVQ), perceptual voice analysis, fiberoptic laryngoscopic and videolaryngostroboscopic examinations, and acoustic analysis were carried out before and one month after surgery. The changes in these values after surgery and the differences between the transoral and open groups were analyzed. Results: We found no significant postoperative change in voice workups in either group. The mean high pitch decreased (from 367.91 ± 120.98 to 325.80 ± 100.86 Hz, p = 0.069) in the transoral group, but statistical significance was not attained. Clinically significant changes in pitch (postoperative change in speaking fundamental frequency, ΔSFF ≥ 12) after surgery were evident in seven (15.91%) patients in the transoral group and eight (21.05%) patients in the open group without significant difference (p = 0.579). Conclusions: This is the first study to assess functional voice outcomes (including pitch) after TOETVA compared with conventional open surgery. TOETVA was associated with good voice outcomes without any significant drop in pitch.

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“…This is consistent with the results of previous studies [ 2 , 12 - 16 ], which proposed that pathological changes in thyroid patients’ voices primarily occur immediately after an operation and are characteristically temporary, with recovery over time. In particular, the fundamental frequency of the thyroidectomy patient’s voice clearly declines during the immediate postoperative period [ 12 , 17 ], and the cepstral analysis, which is based on the exact calculation of the fundamental frequency, adequately reflects this characteristic. This suggests that this decline in the fundamental frequency after the operation is due to the inability of the cricothyroid muscle, which affects the length adjustment of the vocal cords, to function properly with regard to muscle tension after surgery [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Cepstral Analysis of Voice in Patients With Thyroidectomy

Shin

Hong

2016

Clin Exp Otorhinolaryngol

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ObjectivesThe vocal changes after a thyroidectomy are temporary and nonsevere, therefore, obtaining accurate analytical results on the pathological vocal characteristics following such a procedure is difficult. For a more objective acoustic analysis, this study used the cepstral analysis method to examine changes in the patients’ voices during the perioperative period regarding sustained vowel phonation.MethodsThe sustained phonation of the five vowels (i.e., /a/, /e/, /i/, /o/, and /u/) by 35 patients with thyroidectomy were recorded by using a Multi-Speech program. Of the 35 patients, 10 were men and 25 were women, with an average age of 51.5 years. Voice data were collected a total of 3 times (preoperatively, 5–7 days after the operation, and 6 weeks after the operation) and were edited according to each fragment (on-set, mid, and off-set) for cepstral analysis.ResultsThe cepstral analysis on the patients’ voices revealed no significant differences between the examination periods of all vowel phonations. However, analysis of the on-set fragment of the vowel /i/ revealed pathological characteristics in which the cepstral measurements of the voice were significantly lower after the operation than before the operation, with the cepstral measurements of the voice increasing further 6 weeks following surgery.ConclusionThe results of the acoustic analysis on the on-set fragment of the vowel /i/ will be important data for characterizing the vocal changes during the perioperative period. This study contributes to future research on the mechanisms underlying changes in the voice of patients with a history of thyroid or neck surgery.

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Therapeutic Approach to Patients With a Lower‐Pitched Voice After Thyroidectomy

Cited by 16 publications

References 31 publications

Lateral neck dissection affects the voice in thyroid cancer patients

Lateral neck dissection affects the voice in thyroid cancer patients

Can Voice Pitch Be Preserved in Patients after Transoral Endoscopic Thyroidectomy Vestibular Approach?

Cepstral Analysis of Voice in Patients With Thyroidectomy

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