Endocrine Abstracts

Objectives: We aimed to evaluate the impact on postoperative voice outcome according to the degree of thyroidectomy skin flap.

Methods: We randomly enrolled the patients underwent thyroidectomy into conventional thyroidectomy group (group 1) or minimally skin elevated thyroidectomy group (group 2). Skin flap was elevated to thyroid notch superiorly in group 1 and to superior border of cricoid cartilage superiorly in group 2. Inferior border of skin flap was sternal notch in both two groups. Preoperative, 2-weeks and 3-months postoperative voice handicap index (VHI), F0, jitter, shimmer, and noiseto-harmony ratio (NHR) were estimated. Then we retrospectively analyzed these voice parameters and compared them between two groups.

Results: A total of 35 thyroidectomy patients was divided into group 1 with 16 patients and group 2 with 19 patients (M:F=5:30). All patients were performed central neck dissection with thyroidectomy (total thyroidectomy, 5 patients; hemithyroidectomy, 30 patients). Immediate postoperative vocal fold paralysis occurred in 3 patients, which was all recovered. VHI, jitter, and shimmer were significantly increased 2 weeks after surgery (VHI, P = 0.001; jitter, P = 0.022; shimmer, P= 0.019), but there were no differences of voice parameters between before surgery and 3 months after surgery. When comparing the differences of voice parameters between group 1 and 2, there were no differences at 2 weeks after surgery and 3 months after surgery.

Conclusion: The extent of skin flap in thyroidectomy may not correlated with postoperative voice outcome. Surgeons can decide appropriate degree of skin flap of thyroidectomy based on patient’s condition, tumor factor, and surgeons’ preferences.