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Surgery. 2018 Apr;163(4):796-800. doi: 10.1016/j.surg.2017.09.023. Epub 2017 Nov 20.

Long-term voice quality outcomes after total thyroidectomy: a prospective multicenter study.

Author information

1
Clinique de Chirurgie Digestive et Endocrinienne, Hôtel Dieu, CHU de Nantes, Nantes, France.
2
Chirurgie Digestive, Générale et Endocrinienne, CHU de Limoges, Limoges, France.
3
Chirurgie Vasculaire, CHD Vendée, La Roche sur Yon, France.
4
Endocrinologie, Maladies Métaboliques et Nutrition, CHU de Nantes (Hôpital Laennec), Saint-Herblain, France.
5
Oto-Rhino-Laryngologie, Hôtel Dieu, CHU de Nantes, Nantes, France.
6
Clinique de Chirurgie Digestive et Endocrinienne, Hôtel Dieu, CHU de Nantes, Nantes, France. Electronic address: eric.mirallie@chu-nantes.fr.

Abstract

BACKGROUND:

Postthyroidectomy voice disorders can occur without any recurrent laryngeal nerve injury, and probably are the most frequent complication after thyroidectomy. We report the long-term voice quality outcomes after total thyroidectomy without vocal cord palsy using a simple self-assessment tool: the voice handicap index self-questionnaire.

METHODS:

This observational prospective multicenter study included 203 patients from the "ThyrQoL" study (ClinicalTrial NCT02167529), who underwent total thyroidectomy between October 2014 and August 2015 in 3 French Hospitals (Nantes, La Roche-sur-Yon, and Limoges). Exclusion criteria included confirmed malignant disease, age <18 years, and preoperative voice troubles with confirmed vocal cord palsy. Direct flexible laryngoscopy was performed after surgery. Nineteen patients with a postoperative vocal cord palsy were excluded from analysis.

RESULTS:

One hundred and seventy-six patients with no vocal cord palsy were analyzed. Voice handicap index scores were significantly altered on postoperative month 2 compared with preoperative values (7.02 ± 11.56 vs 14.41 ± 19.44; P<.0001). Voice handicap index scores were not significantly different on postoperative month 6 compared with preoperative values (7.02 ± 11.56 vs 7.61 ± 14.02; P=.381). Thirty-six patients (20.5%) described significant voice impairment 2 months after total thyroidectomy. Nine patients (5.7%) still experienced significant discomfort at 6 months.

CONCLUSION:

Twenty percent of patients had initial voice impairment at 2 months postthyroidectomy, with a progressive recovery to preoperative levels at 6 months with <6% with persistent voice complaints.

PMID:
29162343
DOI:
10.1016/j.surg.2017.09.023
[Indexed for MEDLINE]

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