Prediction of Voice Outcomes After Hemithyroidectomy Using Skin Electrode Intraoperative Neuromonitoring
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Background and Objectives This study focused on predicting voice outcomes followinghemithyroidectomy using skin electrode intraoperative neuromonitoring (IONM). Subjects and Method The study involved 82 patients who underwent hemithyroidectomy. During the surgery, the researchers recorded skin IONM values for the vagus nerve and recur-rent laryngeal nerve. Voice quality evaluations were conducted before the surgery and at vari-ous intervals after the surgery (one week, one month, three months, six months, and one year)using the multidimensional voice program (MDVP), voice handicap index (VHI), and thegrade, roughness, breathiness, asthenia, strain (GRBAS) scale. The study aimed to correlateperioperative skin IONM values with subjective and objective voice outcomes. Results The VHI scores increased up to three months post-surgery, with statistically signifi-cant changes observed at one week post-surgery. The GRBAS scale scores also increased sig-nificantly at one month post-surgery. Similar trends were observed in the MDVP data, includ-ing a decrease in the maximum pitch between one week and three months post-surgery. Additionally, the study found that lower delta-V values (difference between the preoperativeand postoperative signal amplitude of vagus nerve stimulation) were associated with higherF0 values at one week and three months post-surgery, while jitter and noise-to-harmonic ratiowere higher in the group with higher delta-V values at three months post-surgery. Conclusion Greater differences between the preoperative and postoperative signal ampli-tude of vagus nerve stimulation during surgery were linked to worse postoperative voice out-comes. Voice parameters worsened for up to 3 months after hemithyroidectomy but showedsigns of recovery afterwards. These findings offer insights into predicting and managing voiceoutcomes after hemithyroidectomy.
Abstract
Background and Objectives This study focused on predicting voice outcomes followinghemithyroidectomy using skin electrode intraoperative neuromonitoring (IONM). Subjects and Method The study involved 82 patients who underwent hemithyroidectomy. During the surgery, the researchers recorded skin IONM values for the vagus nerve and recur-rent laryngeal nerve. Voice quality evaluations were conducted before the surgery and at vari-ous intervals after the surgery (one week, one month, three months, six months, and one year)using the multidimensional voice program (MDVP), voice handicap index (VHI), and thegrade, roughness, breathiness, asthenia, strain (GRBAS) scale. The study aimed to correlateperioperative skin IONM values with subjective and objective voice outcomes. Results The VHI scores increased up to three months post-surgery, with statistically signifi-cant changes observed at one week post-surgery. The GRBAS scale scores also increased sig-nificantly at one month post-surgery. Similar trends were observed in the MDVP data, includ-ing a decrease in the maximum pitch between one week and three months post-surgery. Additionally, the study found that lower delta-V values (difference between the preoperativeand postoperative signal amplitude of vagus nerve stimulation) were associated with higherF0 values at one week and three months post-surgery, while jitter and noise-to-harmonic ratiowere higher in the group with higher delta-V values at three months post-surgery. Conclusion Greater differences between the preoperative and postoperative signal ampli-tude of vagus nerve stimulation during surgery were linked to worse postoperative voice out-comes. Voice parameters worsened for up to 3 months after hemithyroidectomy but showedsigns of recovery afterwards. These findings offer insights into predicting and managing voiceoutcomes after hemithyroidectomy.
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