Self-assessment of voice outcomes after total thyroidectomy using the Voice Handicap Index questionnaire: Results of a prospective multicenter study.

BACKGROUND: Voice disorders are frequent after thyroidectomy. We report the long-term voice quality outcomes after thyroidectomy using the voice handicap index self-questionnaire. METHODS: Eight hundred patients who underwent total thyroidectomy between 2014 and 2017 in 7 French hospitals were prospectively included. All patients filled in voice handicap index questionnaires, preoperatively and 2 and 6 months after surgery. RESULTS: Median (range) voice handicap index scores were significantly increased at month 2 (4 [0; 108]) compared to preoperative values (2 [0; 76]) and were unchanged at month 6 (2 [2; 92]). Clinically significant voice impairment (voice handicap index score difference ≥18 points) was reported in 19.7% at month 2 and 13% at month 6. Thirty-seven (4.6%) had postoperative vocal cord palsy. In patients with vocal cord palsy compared to those without, median voice handicap index scores were increased at month 2 (14 [0; 107] vs 4 [0; 108]; P = .0039), but not at month 6 (5 [0; 92] vs 2 [0; 87]; P = .0702). Clinically significant impairment was reported in 38% vs 19% at month 2 (P = .010), and in 19% vs 13% at month 6 (P = .310). Thyroid weight, postoperative hypocalcemia, vocal cord palsy, and absence of intraoperative neuromonitoring utilization were associated with an increased risk of clinically significant self-perceived voice impairment at month 2. CONCLUSION: Thyroidectomy impairs patients' voice quality perception in patients with and without vocal cord palsy.

Correlation of the Iranian Voice Quality of Life Profile (IVQLP) with Acoustic Measurements across Three Common Voice Disorders.

OBJECTIVES: The Iranian Voice Quality of Life Profile (IVQLP) is a recent culture-based developed tool for assessing the quality of life of dysphonic patients. The research questions addressed here are as follows: (1) Are the correlations between IVQLP scores and values of objective voice measures? (2) Do the correlations differ across the three different voice disorders? METHODS: The subjects were divided into three groups: muscle tension dysphonia (MTD) (n = 62), benign midmembranous vocal fold lesions (n = 56), and unilateral vocal fold paralysis (UVFP) (n = 32). The study sample consisted of 91 males and 59 females. The individuals had a mean age of 46.53 ± 13.84 years. All of the participants completed the IVQLP questionnaire. The PRAAT software was used to provide acoustic analyses. The correlations between fundamental frequency (F0), perturbation analyses, harmonics-to-noise ratio, and IVQLP data of the three groups of patients were measured using Pearson's correlation. RESULTS: There was a significant correlation between the total score and jitter in the MTD group. For the benign vocal fold lesion group, correlations were significant and relatively strong for numerous analyses. Again, there were numerous significant and strong correlations for the UVFP group. CONCLUSIONS: Results may indicate two interpretations. One interpretation of the results is that patients with morphological tissue changes (lesions, paralysis) appear to associate their sense of how their voice problem negatively affects their lives. A second interpretation is that there is perhaps a threshold of vocal perturbation or instability that lends itself to a patient's connection to his or her sense of how the voice affects his or her quality of life.

Effect of complicated thyroid surgical procedures on personal and professional life of patients.

UNLABELLED: Thyroid resection procedures are the most common endocrine surgery procedures in Poland; an estimated 25,000 procedures are performed annually. Long term patient outcomes are rarely analyzed. THE AIM OF THE STUDY: was to assess effect of complicated thyroid burgery procedures on personal and Professional life of patients. MATERIAL AND METHODS: Follow-up of patients with complications was conducted according to a predetermined protocol involving survey and biochemistry. RESULTS: Unilateral and bilateral vocal cord paralysis accounted for 69% and 8% of complications, respectively. The complications resolved unilaterally in 58% of patients with bilateral vocal cord paralysis. Persistent hypoparathyroidism accounted for 26% of cases of postoperative hypoparathyroidism. Following thyroid resection procedures all patients received supplementation of thyroid hormones and were monitored by an endocrinologist until their follow-up examination. Eighty eight percent patients with vocal cord paralysis were treated at an outpatient department of laryngology and/or speech therapy. Physical therapy resulted in improvement irrespective of final nature of the complications. Vocal cord paralysis or both complications concurrently result in marked prolongation of absence from work and resulted in disability pension in 15% of professionally active patients. Low level of adaptation to disease was found in 19% patients in the study group, while low score on Satisfaction with Life Scale (SWLS) was found in 17% patients in the study group, irrespective of the type of complication. CONCLUSIONS: Acceptance of complications after thyroid surgical procedures is difficult for patients and worsens their life satisfaction in the long term follow-up and adversely modifies their professional and personal life. In the long term perspective, persistent hypoparathyroidism is more burdensome for patients than recurrent laryngeal nerve injury. Chronic deficit of innervations does not require chronic substitution or specialist therapy that are necessary in the persistent hypoparathyroidism.

Update on pediatric voice and airway disorders: assessment and care.

PURPOSE OF REVIEW: To investigate the status of the recent literature focused on studying the assessment and treatment of pediatric voice and airway disorders using both established and novel techniques. RECENT FINDINGS: Recent research regarding voice assessment and treatment reveals the use of systematic and innovative approaches when collecting instrumental and perceptual voice data. There are recent advancements in certain surgical interventions designed to minimize complications. Wider use of functional endoscopic imaging of the pediatric larynx is improving our understanding of childhood voice production and airway management. There is also an important emerging focus on quantifying the impact of having a childhood voice disorder through the use of new tools. Although there is an increase in pediatric voice and airway research, many studies tend to be entirely descriptive rather than quantitative. There continues to be little specific research that uses prospective, longer-term and formal voice outcomes before and after behavioral and surgical interventions. SUMMARY: Pediatric voice and airway disorders are an important childhood health problem. Voice assessment in children should include formal perceptual and instrumental evaluations, including sophisticated acoustic, aerodynamic and imaging modalities. The care of these children requires a collaborative approach that includes systematic and innovative treatment methods.