Preoperative Voice Characteristics in Thyroid Patients

Introduction: Thyroid surgery outcomes have evolved from mortality control strategies to morbidity control measures. Most vocal outcomes research in thyroid surgery are focused on recurrent nerve anatomic and functional preservation. However, there are likely multiple causes of vocal dysfunction in thyroid patients. We prospectively analyzed preoperative patients with thyroid disease to define preoperative vocal characteristics of this population. Objective: Quantify vocal and laryngeal baseline conditions in thyroid surgical patients. Methods: Prospective study of preoperative stroboscopy findings and vocal function assessing the correlation between thyroid disease, compressive symptoms, baseline vocal conditions and laryngoscopy results. Results: Vocal quantitative scores were positive for dysphonia in 36% of patients and the Vocal Handicap Index confirmed either slight or Moderate impairment in most patients. Stroboscopy results were abnormal in 60% of cases with no diagnoses of immobility. Correlation was established for diagnosis of cancer and the absence of symptoms. Conclusions: These results point to a multifactorial cause for vocal impairment in thyroid surgery patients. Research on vocal impairment in thyroid surgery should not be centered exclusively on recurrent nerve neuromonitoring and functional preservation, but also on other variables that may contribute to vocal change in thyroid disease and surgery.