Voice in Thyroid Surgery Without Vocal Fold Immobility

Author(s): Sara I. R. Viana Baptista, David G. Lott, Sancha C. C. Almeida, Maria Olimpia Cid, Paulo S. Vera-Cruz

Introduction: Voice outcomes are of central importance in modern thyroid surgery. General Surgeons and Otolaryngologists (ENT) usually have different perspectives and value different criteria for successful assessment of voice issues.

Objective: Describe vocal changes in thyroid surgery patients.

Methods: Retrospective descriptive study for 171 patients who underwent hemi or total thyroidectomy. Vocal complaints, vocal handicap indexes (VHI) scores and laryngostroboscopic (LE) results were assessed. Results: 38% of patients reported laryngopharyngeal complaints preoperatively but only one patient had immobility.

Conclusions: Care must be taken when assuming that vocal changes in thyroid surgery result only or mainly from recurrent nerve injury. From 38% of patients with pre-operative vocal complaints only 0.5% of patients had immobility. Vocal changes in thyroid surgery are likely multifactorial and this study demonstrates that vocal fold immobility is not the only etiologic factor. Alternative causes for vocal changes in thyroid pathology and surgery must be investigated.

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