갑상선 수술 후 음성 변화
Voice-related Outcome after Thyroidectomy
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: Vocal symptoms have been reported after thyroidectomy and even in the absence of injury to the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve. The aim of this prospective study was to evaluate the subjective and objective voice changes in patients without laryngeal nerve injury after thyroidectomy. Methods: The subjects had undergone total thyroidectomy for differentiated thyroid carcinoma from November 2007 to December 2008. Twenty-eight subjects (males: 8, females: 20) were selected for this study. Voice analysis was prospectively evaluated in the subjects at the time of preoperation and postoperation (10.8 months for the males and 11.7 months for the females). A subjective analysis was done using the visual analogue scale (VAS, 0: no symptom, 10: severe symptoms) and objective analyses were determined by several parameters such as the fundamental frequency (Fo), jitter, shimmer and the noise to harmonic ratio (NHR) using the multi-dimensional voice program. Maximum phonation time (MPT)was performed as an aerodynamic test. Results: 3 patients (37.5%) among the males and 14 patients (70%) among the females had subjective postoperative voice change. The VAS showed a significant difference for the females (0 to 1.25±0.97, P＜0.001), whereas no changes were shown for the males (0 to 0.88±1.25, P＞0.05). The vocal parameters (Fo, jitter, shimmer, NHR) and MPT showed no significant changes for both the males and females (P＞0.05). Conclusion: Subjective voice changes may occur after thyroidectomy without laryngeal nerve injury. Surgeons should take possible voice changes into consideration when informing patients before thyroidectomy. (Korean J Endocrine Surg 2011;11:175-178)
Abstract
Purpose: Vocal symptoms have been reported after thyroidectomy and even in the absence of injury to the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve. The aim of this prospective study was to evaluate the subjective and objective voice changes in patients without laryngeal nerve injury after thyroidectomy. Methods: The subjects had undergone total thyroidectomy for differentiated thyroid carcinoma from November 2007 to December 2008. Twenty-eight subjects (males: 8, females: 20) were selected for this study. Voice analysis was prospectively evaluated in the subjects at the time of preoperation and postoperation (10.8 months for the males and 11.7 months for the females). A subjective analysis was done using the visual analogue scale (VAS, 0: no symptom, 10: severe symptoms) and objective analyses were determined by several parameters such as the fundamental frequency (Fo), jitter, shimmer and the noise to harmonic ratio (NHR) using the multi-dimensional voice program. Maximum phonation time (MPT)was performed as an aerodynamic test. Results: 3 patients (37.5%) among the males and 14 patients (70%) among the females had subjective postoperative voice change. The VAS showed a significant difference for the females (0 to 1.25±0.97, P＜0.001), whereas no changes were shown for the males (0 to 0.88±1.25, P＞0.05). The vocal parameters (Fo, jitter, shimmer, NHR) and MPT showed no significant changes for both the males and females (P＞0.05). Conclusion: Subjective voice changes may occur after thyroidectomy without laryngeal nerve injury. Surgeons should take possible voice changes into consideration when informing patients before thyroidectomy. (Korean J Endocrine Surg 2011;11:175-178)
참고문헌 (16)
- Van Lierde K, "Impact of thyroidectomy without laryngeal nerve injury on vocal quality characteristics: an objective multiparameter approach", Laryngoscope, 120, pp.338~345 (2010)
- Debruyne F, "Acoustic analysis of the speaking voice after thyroidectomy", J Voice, 11, pp.479~482 (1997)
- de Pedro Netto I, "Voice and vocal self-assessment after thyroidectomy", Head Neck, 28, pp.1106~1114 (2006)
- Lombardi CP, "Long-term outcome of functional post-thyroidectomy voice and swallowing symptoms", Surgery, 146, pp.1174~1181 (2009)
- Stojadinovic A, "Prospective functional voice assessment in patients undergoing thyroid surgery", Ann Surg, 236, pp.823~832 (2002)
- Hong KH, "Phonatory characteristics of patients undergoing thyroidectomy without laryngeal nerve injury", Otolaryngol Head Neck Surg, 117, pp.399~404 (1997)
- Sinagra DL, "Voice changes after thyroidectomy without recurrent laryngeal nerve injury", J Am Coll Surg, 199, pp.556~560 (2004)
- McIvor NP, "Thyroid surgery and voice-related outcomes", Aust N Z J Surg, 70, pp.179~183 (2000)
- Crumley RL, "Repair of the recurrent laryngeal nerve", Otolaryngol Clin North Am, 23, pp.553~563 (1990)
- Teitelbaum BJ, "Superior laryngeal nerve injury from thyroid surgery", Head Neck, 17, pp.36~40 (1995)
- Gupta OP, "Nasal, pharyngeal, and laryngeal manifestations of hypothyroidism", Ear Nose Throat J, 56, pp.349~356 (1977)
- Zimmert M, "Effects on vocal function and incidence of laryngeal disorder when using a laryngeal mask airway in comparison with an endotracheal tube", Eur J Anaesthesiol, 16, pp.511~515 (1999)
- Kark AE, "Voice changes after thyroidectomy: role of the external laryngeal nerve", Br Med J (Clin Res Ed), 289, pp.1412~1415 (1984)
- Akyildiz S, "A multivariate analysis of objective voice changes after thyroidectomy without laryngeal nerve injury", Arch Otolaryngol Head Neck Surg, 134, pp.596~602 (2008)
- Stojadinovic A, "Prospective trial of voice outcomes after thyroidectomy: evaluation of patient-reported and clinician-determined voice assessments in identifying postthyroidectomy dysphonia", Surgery, 143, pp.732~742 (2008)
- Mupparapu M, "Ossification of laryngeal cartilages on lateral cephalometric radiographs", Angle Orthod, 75, pp.196~201 (2005)