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The Impact of Thyroidectomy on Vocal Quality Characteristics

by Sue Pondrom •

With no laryngeal nerve injury, do vocal characteristics change after thyroidectomy?

Background: Vocal dysfunction is a feared complication of thyroidectomy. While operative injury to the recurrent laryngeal nerve is a primary cause of voice alterations, changes have also been noted in the absence of this injury.

Study design: Prospective study of patients one week prior and one week, six weeks and three months after surgery

Setting: Subjective (auditory perceptual evaluation and videolaryngostroboscopy) and objective (aerodynamic, vocal range, acoustic and Dysphonia Severity Index (DSI)) assessments were utilized with 44 thyroidectomy patients in Belgium.

Synopsis: No significant differences were found in the Voice Handicap Index questionnaire between the preoperative and postoperative points. While complaints of roughness and vocal fatigue were reported one week after surgery, complaints decreased significantly by subsequent evaluations.

In the auditory perceptual evaluation, one week after surgery the overall grade of dysphonia and roughness were significantly higher than pre-surgery. However, the Wilcoxon test showed no significant differences between further evaluations and the pre-surgical assessment. The videostroboscopic evaluation showed no significant differences as to symmetry, regularity, glottic closure and mucosal wave.

The objective data indicated a significant decrease of the highest frequency, intensity, fundamental frequency and objective vocal quality by means of the DSI value at one week post-surgery. When repeated analysis of variance was later performed, no significant differences were noted.

Bottom line: Although more vocal complaints occurred immediately after thyroidectomy, patients had a normal perceptual and objective vocal quality with no permanent change of vocal performance at six week and three month evaluations.

Citation: Lierde KV, D’haeseleer E, Wuyts FL, et al. Impact of thyroidectomy without laryngeal nerve injury on vocal quality characteristics: An objective multiparameter approach. The Laryngoscope. 2009;120(2):338-345.