Skip to main content
SpringerLink
Log in

Perceptual and Acoustic Analysis of Voice in Individuals with Total Thyriodectomy: Pre-Post Surgery Comparison

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

An Erratum to this article was published on 23 February 2011

An Erratum to this article was published on 23 February 2011

Abstract

Total thyroidectomy (TT) is a surgical procedure which involves complete removal of the thyroid gland, usually done in massive goitre compressing the trachea and esophagus, hyperthyroidism and carcinoma of thyroid gland. Laryngeal nerve damage is one of the most feared complications after TT which can lead to permanent changes in voice. Recent research suggests the occurrence of voice changes without any visible laryngeal nerve damage. Present study attempts to compare the pre and post-operative voice characteristics in individuals with total thyroidectomy without any laryngeal nerve damage. A total of 27 subjects (21 females and 6 males) who underwent total thyroidectomy participated in the study. Their recorded phonation of vowel/a/was subjected to two types of analyses viz. Perceptual analysis (using CAPE-V rating scale) and Acoustic analysis (using Multi Dimensional Voice Profile). Results of perceptual analysis indicated slight decrease in overall severity, roughness and breathiness and a slight increase in strainness, in only males. Acoustic analysis findings supported perceptual results with minimal changes in most of the parameters. The results suggest that after total thyroidectomy, in the absence of visible laryngeal nerve damage, functional changes in voice are minimal and temporary in nature. This study provides an insight to Otolaryngologists and Speech Language Pathologists about the voice characteristics in individuals with thyroidectomy, enabling them to formulate appropriate therapy protocol for this population. It further attempts to sensitize surgeons and physicians on the need for referral of this population to Speech Language Pathologist in the event of dysphonia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Akyildiz S, Ogut F, Akyildiz M, Engin EZ (2008) A multivariate analysis of objective voice changes after thyroidectomy without laryngeal nerve injury. Arch Otolaryngol Head Neck Surg 134(6):596–602

    Article  PubMed  Google Scholar 

  2. Holt GR, McMurry CT (1977) Recurrent nerve injury following thyroid operations. Surg Gynecol Obstet 144:567–570

    PubMed  CAS  Google Scholar 

  3. Hong KH, Kim YK (1997) Phonatory characteristics of patients undergoing thyroidectomy without laryngeal nerve injury. Otolaryngol Head Neck Surg 117(4):399–404

    Article  PubMed  CAS  Google Scholar 

  4. Aluffi P, Policarpo M, Cherovac C, Olina M, Dosdegani R, Pia F (2001) Post-thyroidectomy superior laryngeal nerve injury. Eur Arch Otorhinolaryngol 258(9):451–454

    Article  PubMed  CAS  Google Scholar 

  5. Stojadinovic A, Shaha AR, Orlikoff RF et al (2002) Prospective functional voice assessment in patients undergoing thyroid surgery. Ann Surg 236(6):823–832

    Article  PubMed  Google Scholar 

  6. Debruyne F, Ostyn F, Delaere P, Wellens W (1997) Acoustic analysis of the speaking voice after thyroidectomy. J Voice 11(4):479–482

    Article  PubMed  CAS  Google Scholar 

  7. Sinagra DL, Montesinos MR, Tacchi VA, Moreno JC, Falco JE, Mezzadri NA et al (2004) Voice changes after thyroidectomy without recurrent laryngeal nerve injury. J Am Coll Surg 199(4):556–560

    Article  PubMed  Google Scholar 

  8. McIvor NP, Flint DJ, Gillibrand J, Morton RP (2000) Thyroid surgery and voice -related outcomes. Aust N Z J Surg 70(3):179–183

    Article  PubMed  CAS  Google Scholar 

  9. Stojadinovic A, Henry LR, Howard RS, Gurevich-Uvena J, Makashay MJ, Coppit GL, Shriver CD (2008) Prospective trial of voice outcomes after thyriodectomy: evaluation of patient-reported and clinician-determined voice assessments in identifying postthyriodectomy dysphonia. Surgery 143(6):732–741

    Article  PubMed  Google Scholar 

  10. Kempster GB, Gerratt BR, Abbott KV, Kraemer JB, Hillman RE (2009) Consensus Auditory-Perceptual Evaluation of voice: Development of a standardized clinical Protocol. Am J Speech Lang Pathol 18:124–132

    Article  PubMed  Google Scholar 

  11. Musholt TJ, Musholt PB, Garm J, Napiontek U, Keilmann A (2006) Changes of the speaking and singing voice after thyroid or parathyroid surgery. J Surg 140(6):978–988

    Article  Google Scholar 

  12. Page C, Zaatar R, Biet A, Strunski V (2007) Subjective voice assessment after thyroid surgery: a prospective study of 395 patients. Indian J Med Sci 61(8):448–454

    Article  PubMed  CAS  Google Scholar 

  13. Watt-Boolsen S, Blichert-Toft M, Boberg A (1979) Influence of thyroid surgery on voice function and laryngeal symptoms. Br J Surg 66(8):535–536

    Article  PubMed  CAS  Google Scholar 

  14. Lombardi CP, Raffaelli MD, Alatri L, Marchese MR, Rigante M, Paludetti G et al (2006) Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuries. J Surg 140(6):1026–1034

    Article  Google Scholar 

  15. Hollien H, Jackson B (1973) Normative data on the speaking fundamental frequency characteristics of young adult males. J Phonet 1:117–120

    Google Scholar 

  16. Murry T, Dherry ET (1980) Selected acoustics characteristics of pathologic and normal speakers. J Speech Hear Res 23:362–369

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Speech and Hearing, Manipal College of Allied Health Sciences, Manipal University, Manipal, Karnataka, 576194, India

    M. Santosh & B. Rajashekhar

Authors
  1. M. Santosh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Rajashekhar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Santosh.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s12070-011-0164-3

Appendix: Compendium of the Definitions of Different Acoustic Parameters Used in the Present Study

Appendix: Compendium of the Definitions of Different Acoustic Parameters Used in the Present Study

Frequency Related Parameters:

  • Mean Fundamental Frequency (MF0): Average fundamental frequency for all extracted pitch periods.

  • Highest Fundamental Frequency (Fhi): The highest value of frequency that is noticed.

  • Lowest Fundamental Frequency (Flo): lowest frequency that is noticed.

  • Standard Deviation of F0 (STD): deviation of F0 from average.

Pertubation Related Parameters:

  • Absolute Jitter (Jitta): Period to period variability of the pitch period.

  • Jitter Percent (Jitt): Period to period (very short term) variability of the pitch.

  • Relative Average Perturbation (RAP): Period to period variability of the pitch with smoothing factor of 3 periods.

  • Pitch Perturbation Quotient (PPQ): Period to period variability of the pitch with smoothing factor of 5 periods.

  • Smoothed Pitch Perturbation Quotient (sPPQ): Short or long term variability of the pitch period at smoothing factor defined by the user.

  • Shimmer in dB (ShdB): Evaluation in dB of the period to period variability of the peak to peak amplitude.

  • Shimmer Percent (Shim): Relative evaluation of the period to period variability of the peak to peak amplitude.

  • Amplitude Perturbation Quotient (APQ): Relative evaluation of the period to period variability of the peak to peak amplitude at smoothing level of 11 periods.

  • Smoothed Amplitude Perturbation Quotient (sAPQ): Short or long term variability of the peak to peak amplitude at smoothing factor defined by the user.

Noise and Voice Break Related Parameters

  • Noise to Harmonic Ratio (NHR), Average ratio of the inharmonic spectral energy in the frequency range 1500–4500 Hz to the harmonic spectral energy in the frequency range 70–4500 Hz.

  • Voice Turbulence Index (VTI): Average ratio of the inharmonic high frequency energy in the range 2800–5800 Hz to the spectral harmonic energy in the frequency range 70–4500 Hz in areas of the signal where t he influence of the frequency & amplitude variations, voice breaks & sub harmonic components are minimal.

  • Soft Phonation Index (SPI): Average ratio of the lower frequency harmonic energy in the range 70–1600 Hz to the higher frequency harmonic energy in the range 1600–4500 Hz.

  • Degree of Voice Breaks (DVB): Ratio of the total length of areas representing voice breaks of the time of the complete voice sample.

  • Degree of Voiceless (DUV): Estimated relative evaluation of non harmonic areas where Fo cannot be detected in the sample.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Santosh, M., Rajashekhar, B. Perceptual and Acoustic Analysis of Voice in Individuals with Total Thyriodectomy: Pre-Post Surgery Comparison. Indian J Otolaryngol Head Neck Surg 63, 32–39 (2011). https://doi.org/10.1007/s12070-010-0105-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-010-0105-6

Keywords

Search

Navigation