The Efficacy of Voice Screening Using the Thyroidectomy Related Voice Questionnaires / 대한이비인후과학회지

ABSTRACT

Most common cause of vocal dysfunction after thyroidectomy is nerve injury, but an understanding of the anatomy and surgical techniques associated with such voice problems reduces the risk of damage to these nerves. Despite these efforts, many patients still suffer from voice-related problems without obvious accidental nerve injury or vocal-cord palsy. The possible causes of vocal dysfunction without nerve injury are a strap muscle contraction due to surgery, impairment of laryngeal movement, laryngeal trauma after endotracheal intubation, modification of the vascular supply, and psychological problem. However, multiple means of assessing vocal function are time-consuming, require specific instruments and specialists, and increase costs. Thus, the authors developed the Perioperative Voice-Screening Protocol for Thyroid Surgery using the Thyroidectomy-Related Voice Questionnaire (TVQ). This questionnaire was developed at our institution and is a self-assessment tool that measures quality of voice. It consists of 20 questions; responses to each are scored from a minimum of 0 (no voice alterations or symptoms) to a maximum of 80 (highest voice impairment and multiple vocal symptoms). This questionnaire was developed based on the voice handicap index and it concern general voice complaints, representative symptoms related to LPR and vocal cord palsy, and swallowing-related symptoms associated with thyroidectomy. Based on the results of the study, we recommend that a preoperative voice work-up should be performed in patients with a high preoperative TVQ score (≥5). We also recommend that a postoperative voice work-up should be performed in patients with a high postoperative TVQ score (≥25).