Purpose <p>Voice symptoms following thyroidectomy with intact recurrent laryngeal nerve remain a challenging clinical issue. The association between the extent of surgery and the occurrence of these symptoms is still debated. This study aims to evaluate voice changes after uncomplicated thyroidectomy and assess the severity of these symptoms based on the type of surgery performed.</p> Methods <p>A prospective study was conducted from March 2024 to May 2025, involving patients scheduled for thyroid surgery. Voice evaluation was performed using a Multidimensional Voice Assessment, which includes both subjective questionnaire (Vocal Fatigue Index (VFI) and Voice handicap index (VHI)) and objective methods (GRABAS test and CAPE-V test). Assessments were conducted at four time points: pre-operation, three days, one month, and two months after surgery. Then we investigated these voice changes based on the extent of the surgery (lobectomy versus total thyroidectomy).</p> Results <p>Thirty-eight patients, comprising 78.9% females and 21.1% males, were evaluated. We found statistically significant differences on the VFI, VHI, and GRABAS scales across time points, especially at 3 days post-surgery. Patients with total thyroidectomy showed greater changes on VFI and VHI, but these changes were not statistically significant. Total thyroidectomy patients had a lower score on GRABAS and CAPE-V exams than lobectomy patients. Although the differences did not reach conventional statistical significance, they are clinically noteworthy.</p> Conclusions <p>Voice changes after thyroid surgery are detectable using self-assessment questionnaires and perceptual tests. These changes are more prominent early after surgery. Additional studies are needed to evaluate long-term voice changes with objective and subjective tests.</p>

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Voice changes following uncomplicated thyroid surgery: a prospective study in Iranian people

  • Maryam Lotfi,
  • Peyman Zamani,
  • Maryam Kardoni,
  • Alireza Ageneh,
  • Shaghayegh Sherafatmand

摘要

Purpose

Voice symptoms following thyroidectomy with intact recurrent laryngeal nerve remain a challenging clinical issue. The association between the extent of surgery and the occurrence of these symptoms is still debated. This study aims to evaluate voice changes after uncomplicated thyroidectomy and assess the severity of these symptoms based on the type of surgery performed.

Methods

A prospective study was conducted from March 2024 to May 2025, involving patients scheduled for thyroid surgery. Voice evaluation was performed using a Multidimensional Voice Assessment, which includes both subjective questionnaire (Vocal Fatigue Index (VFI) and Voice handicap index (VHI)) and objective methods (GRABAS test and CAPE-V test). Assessments were conducted at four time points: pre-operation, three days, one month, and two months after surgery. Then we investigated these voice changes based on the extent of the surgery (lobectomy versus total thyroidectomy).

Results

Thirty-eight patients, comprising 78.9% females and 21.1% males, were evaluated. We found statistically significant differences on the VFI, VHI, and GRABAS scales across time points, especially at 3 days post-surgery. Patients with total thyroidectomy showed greater changes on VFI and VHI, but these changes were not statistically significant. Total thyroidectomy patients had a lower score on GRABAS and CAPE-V exams than lobectomy patients. Although the differences did not reach conventional statistical significance, they are clinically noteworthy.

Conclusions

Voice changes after thyroid surgery are detectable using self-assessment questionnaires and perceptual tests. These changes are more prominent early after surgery. Additional studies are needed to evaluate long-term voice changes with objective and subjective tests.