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The Functional Impact on Voice of Sternothyroid Muscle Division During Thyroidectomy

  • Endocrine Tumors
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Post-thyroidectomy voice dysfunction may occur in the absence of laryngeal nerve injury. Strap muscle division has been hypothesized as one potential contributor to dysphonia.

Methods

Vocal-function data, prospectively recorded before and after thyroidectomy from two high-volume referral institutions, were utilized. Patient-reported symptoms, laryngoscopic, acoustic, and aerodynamic parameters were recorded at 2 weeks and 3 months postoperatively. Patients with and without sternothyroid muscle division during surgery were compared for voice changes. Patients with laryngeal nerve injury, sternohyoid muscle division, arytenoid subluxation or no early postoperative follow-up evaluation were excluded. Differences between study groups and outcomes were compared using t-tests and rank-sum tests as appropriate.

Results

Of 84 patients included, 45 had sternothyroid division. Distribution of age, gender, extent of thyroidectomy, specimen size, and laryngeal nerve identification rates did not differ significantly between groups. There was a significant predilection for or against sternothyroid muscle division according to medical center. No significant difference in reported voice symptoms was observed between groups 2 weeks or 3 months after thyroidectomy. Likewise, acoustic and aerodynamic parameters did not differ significantly between groups at these postoperative study time points.

Conclusion

Sternothyroid muscle division is occasionally employed during thyroidectomy to gain superior pedicle exposure. Division of this muscle does not appear to be associated with adverse functional voice outcome, and should be utilized at surgeon discretion during thyroidectomy.

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, National Naval Medical Center, 8901 Wisconsin Avenue, Bathesda, MD, 20889, USA

    Leonard R. Henry MD

  2. The United States Military Cancer Institute, 6900 Georgia Avenue, Washington, DC, 20307, USA

    Leonard R. Henry MD

  3. Department of Surgery, Army Audiology & Speech Center, Walter Reed Army Medical Center, Washington, DC, 20307, USA

    Nancy Pearl Solomon PhD CCC-SLP & Joyce Gurevich-Uvena MA CCC-SLP

  4. Department of Clinical Investigation, Division of Biostatistics, Walter Reed Army Medical Center, Washington, DC, USA

    Robin Howard MA

  5. Department of Surgery, Division of Anesthesia, Walter Reed Army Medical Center, Washington, DC, USA

    Leah B. Horst MA CCC-SLP

  6. Department of Surgery, Division of Otolaryngology- Head and Neck Surgery, Walter Reed Army Medical Center, Washington, DC, USA

    George Coppit MD

  7. Department of Speech-Language Pathology, Seton Hall University, South Orange, NJ, 07079, USA

    Robert Orlikoff PhD

  8. Surgery Branch, National Cancer Institute, Bethesda, MD, 20889, USA

    Steven K. Libutti MD

  9. Department of Surgical Oncology, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10021, USA

    Ashok R. Shaha MD

  10. Department of Surgery, Division of Surgical Oncology, Walter Reed Army Medical Center and The United States Military Cancer Institute, 6900 Georgia Avenue, Washington, DC, 20307, USA

    Alexander Stojadinovic MD

Authors
  1. Leonard R. Henry MD
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  2. Nancy Pearl Solomon PhD CCC-SLP
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  3. Robin Howard MA
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  4. Joyce Gurevich-Uvena MA CCC-SLP
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  5. Leah B. Horst MA CCC-SLP
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  6. George Coppit MD
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  7. Robert Orlikoff PhD
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  8. Steven K. Libutti MD
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  9. Ashok R. Shaha MD
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  10. Alexander Stojadinovic MD
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Corresponding author

Correspondence to Alexander Stojadinovic MD.

Additional information

The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy (LRH), Department of the Army (GC, AS), Department of Defense, nor the U.S. Government.

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Henry, L.R., Solomon, N.P., Howard, R. et al. The Functional Impact on Voice of Sternothyroid Muscle Division During Thyroidectomy. Ann Surg Oncol 15, 2027–2033 (2008). https://doi.org/10.1245/s10434-008-9936-8

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  • DOI: https://doi.org/10.1245/s10434-008-9936-8

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