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J Korean Soc Laryngol Phoniatr Logop > Volume 21(1); 2010 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2010;21(1): 37-41.
반회후두신경 손상을 동반하지 않은 갑상선 절제술 후 음성 변화
최지선, 정종인, 장민석, 손영익
성균관대학교 의과대학 삼성서울병원 이비인후과학교실
Voice Changes after Thyroidectomy Without Recurrent Laryngeal Nerve Injury
Jee-Sun Choi, Jong-In Jeong, Min-Seok Jang, Young-Ik Son
Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center
ABSTRACT
Background and Objectives
: Transient minor voice changes after thyroidectomy are not infrequent complaints even in cases without any evidence of recurrent laryngeal nerve damage. However, clinical course, diagnosis and management of such voice changes are not fully understood. This study aimed to evaluate the clinical characteristics of minor voice changes after thyroidectomy. We also tried to assess the significance and feasibility of superior laryngeal nerve monitoring and to find out the optimal evaluation tools for such voice changes after thyroidectomy.
Materials and Method
: Nine adult patients who received total thyroidectomy without evidence of recurrent laryngeal nerve injury were enrolled for this prospective study. Voice evaluations were performed preoperatively and 3 months postoperatively ; acoustic analyses including voice range profile, aerodynamic study, stroboscopic evaluation and subjective voice assessment with questionnaires. The external branch of superior laryngeal nerve was monitored by nerve stimulator after ligation of superior thyroidal vessels.
Results:
Four of nine patients complained their voice change at 3 months after the surgery. Three of them reported complete recovery of their voice at 6 months after the surgery. Acoustic analysis revealed significant decrease in their phonatory range especially with high tone loss. Questionnaires related to singing was more sensitive than previously well-known "voice handicap index". Stimulation of the superior laryngeal nerve was feasible in most of the cases (94.4%), but it failed to show any correlation with minor voice changes after thyroidectomy.
Conclusion
: Minor voice changes were not rare events during the first 6 month after thyroidectomy. Decrease in phonatory range with high tone loss and therefore, discomfort in singing was the most common finding. Superior laryngeal monitoring was feasible but it was not a sensitive tool for the prediction of minor voice change after thyroidectomy.
KEY WORDS: Thyroidectomy;Superior laryngeal nerve;Voice;Complication;
중심 단어: 갑상선절제술;상후두신경;음성;합병증;
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