Frédéric Borel1, Christophe Tresallet2, Antoine Hamy3, Muriel Mathonnet4, Jean-Christophe Lifante5, Laurent Brunaud6, Olivier Marret7, Cécile Caillard1, Florent Espitalier8, Delphine Drui9, Fabrice Menegaux2, Jean-Benoit Hardouin10, Claire Blanchard11, Eric Mirallié12. 1. Clinique de Chirurgie Digestive et Endocrinienne, Institut des maladies de l'Appareil Digestif, Hôtel Dieu, CHU Nantes, Place Alexis Ricordeau, Nantes, France. 2. Chirurgie Générale, Viscérale et Endocrinienne, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Universités Pierre et Marie Curie (Paris 6), Paris, France. 3. CHU Angers, Chirurgie digestive et endocrinienne, Angers, France. 4. Chirurgie digestive, générale et endocrinienne, CHU de Limoges, Hôpital Dupuytren, Limoges, France. 5. Chirurgie générale, endocrinienne, digestive et thoracique, Centre Hospitalier Lyon-Sud, Pierre Bénite, France. 6. Service de chirurgie digestive, hépato-biliaire, et endocrinienne, CHU Nancy, Hôpital de Brabois, Nancy, France. 7. Chirurgie Vasculaire, CHD Vendée, La Roche sur Yon, France. 8. Oto-Rhino- Laryngologie et chirurgie cervico-faciale, Hôtel Dieu, CHU de Nantes, Nantes, France; Université de Nantes, quai de Tourville, Nantes, France. 9. Endocrinologie, Maladies Métaboliques et Nutrition, CHU de Nantes (Hôpital Laennec), Saint-Herblain, France; Institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France. 10. UMR INSERM 1246-SPHERE, Université de Nantes, Université de Tours, Institut de Recherche en santé 2, Nantes, France; Plateforme de Méthodologie et de Biostatistique, DRCi, CHU de Nantes, Nantes, France. 11. Clinique de Chirurgie Digestive et Endocrinienne, Institut des maladies de l'Appareil Digestif, Hôtel Dieu, CHU Nantes, Place Alexis Ricordeau, Nantes, France; Université de Nantes, quai de Tourville, Nantes, France; Institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France. 12. Clinique de Chirurgie Digestive et Endocrinienne, Institut des maladies de l'Appareil Digestif, Hôtel Dieu, CHU Nantes, Place Alexis Ricordeau, Nantes, France; Université de Nantes, quai de Tourville, Nantes, France. Electronic address: eric.mirallie@chu-nantes.fr.
Abstract
BACKGROUND: Voice disorders are frequent after thyroidectomy. We report the long-term voice quality outcomes after thyroidectomy using the voice handicap index self-questionnaire. METHODS: Eight hundred patients who underwent total thyroidectomy between 2014 and 2017 in 7 French hospitals were prospectively included. All patients filled in voice handicap index questionnaires, preoperatively and 2 and 6 months after surgery. RESULTS: Median (range) voice handicap index scores were significantly increased at month 2 (4 [0; 108]) compared to preoperative values (2 [0; 76]) and were unchanged at month 6 (2 [2; 92]). Clinically significant voice impairment (voice handicap index score difference ≥18 points) was reported in 19.7% at month 2 and 13% at month 6. Thirty-seven (4.6%) had postoperative vocal cord palsy. In patients with vocal cord palsy compared to those without, median voice handicap index scores were increased at month 2 (14 [0; 107] vs 4 [0; 108]; P = .0039), but not at month 6 (5 [0; 92] vs 2 [0; 87]; P = .0702). Clinically significant impairment was reported in 38% vs 19% at month 2 (P = .010), and in 19% vs 13% at month 6 (P = .310). Thyroid weight, postoperative hypocalcemia, vocal cord palsy, and absence of intraoperative neuromonitoring utilization were associated with an increased risk of clinically significant self-perceived voice impairment at month 2. CONCLUSION: Thyroidectomy impairs patients' voice quality perception in patients with and without vocal cord palsy.
BACKGROUND: Voice disorders are frequent after thyroidectomy. We report the long-term voice quality outcomes after thyroidectomy using the voice handicap index self-questionnaire. METHODS: Eight hundred patients who underwent total thyroidectomy between 2014 and 2017 in 7 French hospitals were prospectively included. All patients filled in voice handicap index questionnaires, preoperatively and 2 and 6 months after surgery. RESULTS: Median (range) voice handicap index scores were significantly increased at month 2 (4 [0; 108]) compared to preoperative values (2 [0; 76]) and were unchanged at month 6 (2 [2; 92]). Clinically significant voice impairment (voice handicap index score difference ≥18 points) was reported in 19.7% at month 2 and 13% at month 6. Thirty-seven (4.6%) had postoperative vocal cord palsy. In patients with vocal cord palsy compared to those without, median voice handicap index scores were increased at month 2 (14 [0; 107] vs 4 [0; 108]; P = .0039), but not at month 6 (5 [0; 92] vs 2 [0; 87]; P = .0702). Clinically significant impairment was reported in 38% vs 19% at month 2 (P = .010), and in 19% vs 13% at month 6 (P = .310). Thyroid weight, postoperative hypocalcemia, vocal cord palsy, and absence of intraoperative neuromonitoring utilization were associated with an increased risk of clinically significant self-perceived voice impairment at month 2. CONCLUSION: Thyroidectomy impairs patients' voice quality perception in patients with and without vocal cord palsy.
Authors: Maria Heikkinen; Elina Penttilä; Mari Qvarnström; Kimmo Mäkinen; Heikki Löppönen; Jussi M Kärkkäinen Journal: Scand J Surg Date: 2021-04-12 Impact factor: 2.360