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J Korean Soc Laryngol Phoniatr Logop > Volume 27(1); 2016 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2016;27(1): 14-17.
갑상선 수술 후 발생하는 음성장애의 치료
정은재
서울대학교 의과대학 이비인후-두경부외과학교실
Voice Care for the Post-Thyroidectomy Dysphonia
Eun-Jae Chung
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
Correspondence  Eun-Jae Chung ,Tel: (02) 2072-0215, Fax: (02) 745-2387, Email: voicechung@gmail.com
Received: 18 May 2016;  Accepted: 19 May 2016.  Published online: 30 June 2016.
ABSTRACT
Hoarseness is a postoperative complication of thyroidectomy, mostly due to damage to the recurrent laryngeal nerve (RLN). Hoarseness may also be brought about via vocal cord dysfunction (VCD) due to injury of the vocal cords from manipulations during anesthesia, as well as from psychogenic disorders and respiratory and upper-GI related infections. The clinician or surgeon should 1) document assessment of the patient’s voice once a decision has been made to proceed with thyroid surgery ; 2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility 3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery 4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery ; 5) inform the anesthesiologist of the results of abnormal preoperative laryngeal assessment in patients who have had laryngoscopy prior to thyroid surgery ; 6) take steps to preserve the external branch of the surperior laryngeal nerve(s) when performing thyroid surgery ; 7) document whether there has been a change in voice between 2 weeks and 2 months following thyroid surgery ; 8) examine vocal fold mobility or refer the patient for examination of vocal fold mobility in patients with a change in voice following thyroid surgery ; 9) refer a patient to an otolaryngologist when abnormal vocal fold mobility is identified after thyroid surgery ; 10) counsel patients with voice change or abnormal vocal fold mobility after thyroid surgery on options for voice rehabilitation.
KEY WORDS: DysphoniaThyroidectomyLaryngeal nerve
중심 단어: 음성장애갑상선절제술반회후두신경상후두신경갑상선 수술 후 증후군
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