Videolaryngoscopy, Vocal Symptoms Assessment, and Voice Acoustic Features in Patients Undergoing Thyroid Surgery

Introduction: Voice changes can occur after thyroidectomy. Injury to the recurrent laryngeal nerve or external branch of the superior laryngeal nerve is the most well-known case of post-thyroidectomy voice disturbances. In addition, endotracheal intubation can add to dysfunction. Laryngeal compression goiter and tumor infiltration are other possible causes of dysphonia, preoperatively.

Objectives: Videolaryngoscopic, vocal symptoms, and voice analysis assessment of patients undergoing thyroidectomy and identify voice disorders before and after surgery.

Methods: Videolaryngoscopy and vocal symptoms assessment and voice acoustic features at the following times: Before surgery (M0), 1 week after surgery (M1), and 3 months after surgery (M2).

Results: A total of 123 patients were included. Before surgery, the main findings with videolaryngoscopy were acidic laryngitis (n = 20), arytenoid asymmetry (n = 14), compression of the hypopharynx (n = 5), and vocal fold paralysis (n = 1). In the immediate postoperative period, vocal fold paralysis (n = 19), edema and hyperemia (n = 8), vocal fold paresis (n = 4), and hematoma (n = 4) were seen, but with regression in the third month of follow-up in most cases. Acoustic analysis indicated a decrease from F0 and increase in other parameters (shimmer, jitter, noise-to-harmonic ratio [NHR], pitch perturbation quotient [PPQ], and amplitude perturbation quotient [APQ]) compared with normative parameters. However, there was no time difference. Forty patients reported hoarseness and fatigue.

Conclusion: In this study, laryngeal lesions were identified in patients undergoing thyroidectomy, some present preoperatively. Decreasing F0 was also identified, indicating the importance of the voice in pre -and postoperative investigations.