Endocrine Abstracts

Post-thyroidectomy syndrome is defined as postoperative problems after thyroidectomy without injury of recurrent laryngeal nerve, and including most common symptom such as vocal fatigue, loss of high-pitch, reduced vocal strength, reduced speaking fundamental frequency also can be presented. In a recent systemic review, F0, shimmer, and MPT was significantly deteriorated only in the early period and not in the late period after thyroidectomy. There have been several questionnaires for subjective voice problem after thyroidectomy; voice handicap index (VHI) and Voice symptom scale (VoiSS), and Thyroidectomy-related voice questionnaire (TVQ). Cepstral analysis is effective in the estimation of dysphonia severity even for highly dysphonic voice samples; CPP appears to correlate well with overall voice quality. In this study, we aimed to assess voice changes after thyroidectomy via subjective and objective parameters in early phase (postoperative 1 month). Totally 96 patients who underwent thyroidectomy without recurrent laryngeal nerve injury at our hospital between April 2018 and June 2022 were enrolled, and all of them performed voice analysis including VH, VFI, MDVP, and CPP preoperatively and postoperatively. There were 37 males and 59 females, and their mean age was 48.39 years old. Among them, 57 patients underwent lobectomy, and 39 patients (including lateral neck dissection in 7 patients) got total thyroidectomy. After 1 month of surgery, even GRBAS scale showed no changes, postoperative subjective voice scale (VHI, VFI) was significantly decreased (P < 0.001, P = 0.002, respectively). In the objective voice score of MDVP, shimmer and EGG score was significantly decreased, and LH ratio showed significantly increased. The VHI and VFI changes between preop and postop had correlation with CPP/a/ and voice range profile (VRP) high pitch. Dividing groups according to sex, only female group showed significantly discomfort after surgery in VHI, VFI, and VRP high pitch. The group highly complained about voice discomfort after surgery was correlated with VFI score, EGG, and VRP high pitch. In spite of negative results in perceptual analysis, subjective discomfort is present in the early postoperative days after thyroidectomy. Comparing VFI to VHI, VFI also be good predictable tools for assessment of patients’ voice problem. In patients with voice discomfort, CPP would be a feasible parameter. Female patients more complained about their postoperative voice problem, and their high pitch voice can be impaired in early postoperative days. Further study was expected to be a large scale with long term follow-up periods.