ETA2023 Poster Presentations Surgery (10 abstracts)
The effect of surgery extent on vocal alteration following thyroidectomy
Malek Mnejja 1 , Mariam Ben Ayed 2 , Moncef Sellami 1 , Asma Abbes 1 , Sofia Ben Jebara 3 , Noura Haddou 4 , Imen Achour 1 , Bouthaina Hammami 1 & Ilhem Charfeddine 1
1Department of Otorhinolaryngology, Habib Bourguiba University Hospital, Sfax Medical School, Tunisia; 2Sfax Medical School, Department of Otorhinolaryngology, Habib Bourguiba University Hospital, Sfax, Tunisia; 3High School of Communication of Tunis, Cosim Laboratory, University of Carthage, Tunisia; 4University Sultan Moulay Slimane, Faculty of Sciences and Techniques, Data4eart Laboratory, Beni Mellal, Morocco
Objectives: Vocal alteration can occur following thyroidectomy with or without a damage of laryngeal nerves. Multiple factors can increase the risk of vocal alteration. We aim to determine the impact of surgery extent on vocal symptoms and endoscopic and acoustic findings.
Materials and methods: In this prospective study, we evaluated the vocal alteration in patients undergoing a partial (PT) or total thyroidectomy (TT). We performed a vocal assessment pre-operatively and at one-month post-operatively; it was based on vocal symptoms, Voice Handicap Index 10 score (VHI-10), laryngeal endoscopy and acoustic parameters. We compared vocal assessment results in the TT and PT groups. We also determined if central neck dissection (CND) was associated to an increased vocal alteration.
Results: We included 51 patients in the study. They underwent a TT or PT in 50.98% and 49.02% respectively. Surgery included a CND in 11 patients either bilateral (17,65%) or unilateral (3,92%). The presence of a vocal fatigue was significantly more encountered in the TT group. The value of VHI-10 score, jitter and shimmer were significantly more increased in the TT group while the Harmonic to noise ratio (HNR) was significantly more decreased in the TT group (table 1). We did not note a significant association between CND and the following parameters: VHI-10 score, vocal fatigue, dysphonia and recurrent laryngeal nerve palsy, jitter, shimmer, mean fundamental frequency (F0) and HNR alteration.
| Vocal assessment method | Partial thyroidectomy (n =26) | Total thyroidectomy (n =25) | P value |
| VHI10 score | 0 [0.14] | 2 [0.28] | 0,049*** |
| Vocal symptoms | |||
| - Dysphonia | 21.05% | 36.84% | 0,238* |
| - Vocal fatigue | 11.76% | 52.63% | 0,005** |
| Endoscopic findings | |||
| - RLN palsy | 5.26% | 11.11% | 0,5* |
| Acoustic parameters | |||
| - F0 | 243.31 [152.8;33.94] | 214.83 [130.94;361.48] | 0.509**** |
| - Jitter | 0.011 [0,0041;0,031] | 0,017 [0,0028;0,06] | 0.028*** |
| - Shimmer | 0.1 [0.05;0.19] | 0.13 [0.065;0.23] | 0.038**** |
| - HNR | 14.37 [6.19;21.74] | 9.51 [3.95;15.5] | 0.001**** |
| VHI10(Voice Handicap Index10), F0(fundamental frequency), RLN(recurrent laryngeal nerve) Statistical test: *Fisher, **chi-square, ***Student,****Mann-Whiteny | |||
Conclusion: TT was associated to a worse vocal outcome in comparison to PT with significantly higher jitter, shimmer and lower HNR values. VHI10 score was also slightly more altered following Total thyroidectomy but without causing a significant handicap. CNT did not affect vocal outcomes.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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