背景甲状腺切除术是一种常规的外科手术,用于治疗良性疾病,恶性,和一些对药物治疗没有反应的甲状腺激素紊乱。甲状腺手术后的语音改变是有据可查的,通常归因于喉返神经功能障碍。然而,尽管喉神经在解剖学上完整,但语音质量的细微变化仍可持续。这项研究旨在量化甲状腺切除术后喉神经完整患者的声音变化,专注于基频,第一共振峰频率,微光强度,和最大发声持续时间。方法这项横断面研究是在印度中部的三级转诊中心进行的,重点是声带功能正常的甲状腺切除术后患者。术前评估包括喉镜检查和使用计算机程序的语音记录,在术后1个月和3个月重复评估。喉镜检查结果正常的患者进行了语音分析,并提供了有关主观语音变化的反馈。PRAAT6.2版软件用于语音分析。结果41例甲状腺手术后喉镜检查结果正常,大多数是女性(85.4%),平均年龄为42.4岁。甲状腺半切除术占41.4%,甲状腺全切除术占58.6%,8例患者接受中央室颈清扫术。除了一个病人,大多数报告称手术后声音没有主观变化.客观嗓音分析显示术后一个月与术前相比有统计学意义的变化,包括基本频率下降5.87%,微光强度下降1.37%,第一共振峰频率下降6.24%,最大发声时长减少4.35%。这些趋势在术后三个月持续,尽管值接近术前水平。结果显示语音参数有统计学意义的变化,特别是基频和第一共振峰频率,在甲状腺全切除术患者中观察到更高的值。闪光强度也表现出轻微的变化。比较半甲状腺切除术和全甲状腺切除术组的基本频率没有显着差异,第一共振峰频率,和微光。然而,最大发声持续时间显示,在术后1个月和3个月时,半甲状腺切除术组均有显著更大的变化.结论声带运动正常的甲状腺切除术后患者的嗓音参数发生明显变化,大多数患者报告没有主观声音变化。研究结果强调了客观语音分析在评估甲状腺切除术后语音结果中的重要性。
Background Thyroidectomy is a routinely performed surgical procedure used to treat benign, malignant, and some hormonal disorders of the thyroid that are not responsive to medical therapy. Voice alterations following thyroid surgery are well-documented and often attributed to recurrent laryngeal nerve dysfunction. However, subtle changes in voice quality can persist despite anatomically intact laryngeal nerves. This study aimed to quantify post-thyroidectomy voice changes in patients with intact laryngeal nerves, focusing on fundamental frequency, first formant frequency, shimmer intensity, and maximum phonation duration. Methodology This cross-sectional study was conducted at a tertiary referral center in central India and focused on post-thyroidectomy patients with normal vocal cord function. Preoperative assessments included laryngeal endoscopy and voice recording using a computer program, with evaluations repeated at one and three months post-surgery. Patients with normal laryngeal endoscopic findings underwent voice analysis and provided feedback on subjective voice changes. The PRAAT version 6.2 software was utilized for voice analysis. Results The study included 41 patients with normal laryngoscopic findings after thyroid surgery, with the majority being female (85.4%) and the average age being 42.4 years. Hemithyroidectomy was performed in 41.4% of patients and total thyroidectomy in 58.6%, with eight patients undergoing central compartment neck dissection. Except for one patient, the majority reported no subjective change in voice following surgery. Objective voice analysis showed statistically significant changes in the one-month postoperative period compared to preoperative values, including a 5.87% decrease in fundamental frequency, a 1.37% decrease in shimmer intensity, and a 6.24% decrease in first formant frequency, along with a 4.35% decrease in maximum phonatory duration. These trends persisted at the three-month postoperative period, although values approached close to preoperative levels. Results revealed statistically significant alterations in voice parameters, particularly fundamental frequency and first formant frequency, with greater values observed in total thyroidectomy patients. Shimmer intensity also exhibited slight changes. Comparison between hemithyroidectomy and total thyroidectomy groups revealed no significant differences in fundamental frequency, first formant frequency, and shimmer. However, maximum phonation duration showed a significantly greater change in the hemithyroidectomy group at both one-month and three-month postoperative intervals. Conclusions This study on post-thyroidectomy patients with normal vocal cord movement revealed significant changes in voice parameters postoperatively, with most patients reporting no subjective voice changes. The findings highlight the importance of objective voice analysis in assessing post-thyroidectomy voice outcomes.