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Voice outcomes after thyroidectomy without superior and recurrent laryngeal nerve injury: VoiSS questionnaire and GRBAS tool assessment

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Abstract

Voice symptoms are frequently reported early after thyroidectomy, even in the absence of laryngeal nerves injury. We evaluated the short-term outcomes of these functional alterations. Thirty-nine patients were enrolled in a prospective observational trial, evaluating voice function before and 3 months after uncomplicated thyroidectomy, using VoiSS as assessed using a validated patient rated questionnaire; and perceptual voice analysis using GRBAS scale (Grade, Roughness, Breathiness, Asthenia, Strain). Impact of dysphonia on patient’s life using VoiSS questionnaire revealed differences between pre- and postoperative assessment. There was statistically significant worsening in the impairment subgroup of VoiSS (p = 0.027). GRBAS evaluation was consistent between the three independent raters but showed differences between pre- and postoperative voice assessment. Age, TSH and a preoperative finding of laryngopharyngeal reflux significantly predicted quality of voice after thyroid surgery (all p < 0.004), as identified by the GRBAS assessment tool, but not type of surgery, gender or smoking status; although prediction of total variance in changes of voice was modest (r 2 = 0.07). Voice changes may occur after thyroidectomy without evident laryngeal nerve injury. Patients should be made aware of possible mild changes in voice even after uncomplicated thyroid surgery and this might be considered to be part of the informed consent.

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Acknowledgments

Hisham Mehanna for methodological guidance; June Jones and Gemma M. Jones for support with data collection.

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Authors and Affiliations

  1. Department of ENT and Head and Neck Surgery, Faculty of Medicine, Comenius University, Antolská 11, 85107, Bratislava, Slovakia

    Miroslav Tedla

  2. Institute of Head and Neck Studies and Education, Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK

    Miroslav Tedla

  3. ENT Department, University Hospitals Coventry and Warwickshire, Coventry, CV2 2DX, UK

    Miroslav Tedla & S. Chakrabarti

  4. Department of Immunology, Faculty of Medicine, Comenius University, Bratislava, Slovakia

    M. Suchankova

  5. The ARDEN NET Centre, ENTES Centre of Excellence, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK

    M. O. Weickert

  6. Centre for Applied Biological and Exercise Sciences, Coventry University, Coventry, CV1 5FB, UK

    M. O. Weickert

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  1. Miroslav Tedla
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  2. S. Chakrabarti
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  3. M. Suchankova
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  4. M. O. Weickert
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Correspondence to Miroslav Tedla.

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Tedla, M., Chakrabarti, S., Suchankova, M. et al. Voice outcomes after thyroidectomy without superior and recurrent laryngeal nerve injury: VoiSS questionnaire and GRBAS tool assessment. Eur Arch Otorhinolaryngol 273, 4543–4547 (2016). https://doi.org/10.1007/s00405-016-4163-6

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  • DOI: https://doi.org/10.1007/s00405-016-4163-6

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