Int Arch Otorhinolaryngol 2014; 18 - a2450
DOI: 10.1055/s-0034-1388691

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

Renata Mizusaki Iyomasa 1, Elaine Lara Mendes Tavares 1, Emanuel Celice Castilho 1, Iury Lima Veloso 1, Jose Vicente Tagliarini 1, Regina Helena Garcia Martins 1
  • 1Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp)

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.