Voice disorders after total thyroidectomy: Prospective patient self-assessment in comparison with traditional and alternative methods of examining the vocal folds

2020 ◽  
Author(s):  
Alexander Shulutko ◽  
Vasiliy Semikov ◽  
Andrey Moiseev ◽  
Elkhan Osmanov ◽  
Yulia Boblak ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Vocal Folds ◽  
Indirect Laryngoscopy ◽  
Alternative Methods ◽  
Original Form ◽  
Self Assessment ◽  
The Third ◽  
The Mean ◽  
The Voice ◽  
Patient Self Assessment

Abstract Background Voice alterations after thyroidectomy with mobile vocal folds are common. Ultrasonography has been used to assess the mobility of the vocal folds after thyroidectomy. Methods 54 patients underwent thyroidectomy. Indirect laryngoscopy, ultrasonography and GRBAS scoring were performed preoperatively,3 days, 2 and 6 months postoperatively. Results On the third postoperative day, the mobility of the vocal folds was preserved in 52 patients and paresis were recorded in 2 patients. All patients after total thyroidectomy noted the presence of voice alteration in the absence of the postoperative paresis of the vocal folds. On the third postoperative day, the voice was impaired by all criteria of the GRBAS scale, but mainly due to roughness (85%). Sixth month postoperatively 62% of the subjects considered the voice to be altered. Asthenia was observed in 39%. On the third postoperative day indirect laryngoscopy revealed the unchanged vocal folds, the symmetrical edema and the shortening of one of the vocal folds in 56%,42% and 1.9%. Six months postoperatively, the vocal folds returned to their original form. Ultrasonography was well correlated to the results of indirect laryngoscopy. Patients with edema of the vocal folds had a significantly higher mean GRBAS grade than patients without edema. The mean GRBAS score decreased from 3.36 to 0.90, 3 days and 6 months postoperatively. Conclusion Voice alteration after total thyroidectomy is always present. Postoperative edema represents a likely main cause of voice alteration and resolves within 6 months. Ultrasonography is recommended as alternative to indirect laryngoscopy in assessing of the vocal folds in thyroid surgery patients.

Is Vocal Cord Assessment before Total Thyroidectomy Required for All Patients?

2019 ◽  
Vol 85 (11) ◽  
pp. 1265-1268
Author(s):  
Birkan Birben ◽  
Sabri Özden ◽  
Sadettin Er ◽  
Bariş Saylam
Keyword(s):  
Total Thyroidectomy ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Univariate Analysis ◽  
Neck Surgery ◽  
Indirect Laryngoscopy ◽  
Surgical History ◽  
History Of ◽  
Independent Variable ◽  
The Mean

We investigated whether laryngoscopy should be performed before total thyroidectomy on all patients without a history of neck surgery. A total of 2523 patients who underwent total thyroidectomy between January 1, 2013, and March 18, 2018, were retrospectively examined. Pre-operative vocal cord examination was performed on 2070 of these patients by the otorhinolaryngology department using indirect laryngoscopy. Patients with a history of neck or thyroid surgery were not included in the study. The patients were evaluated in terms of age, gender, symptom (hoarseness/dyspnea), comorbidity, surgical history, biopsy, nodule diameter, pathological diagnosis, and tracheal deviation. Preoperative vocal cord paralysis was detected in 0.8 per cent of the patients (17/2070). Four patients (23.5%) were male and 13 patients (76.5%) were female. The mean age was 62 (range, 25–82) years. Seven of the 17 patients (41%) were symptomatic, with complaints of dyspnea in five and hoarseness in two. The univariate analysis revealed that a nodule diameter >30 mm and the presence of dyspnea were associated with vocal cord damage. Furthermore, the multivariate analysis showed that dyspnea alone was an independent variable ( P = 0.011). It is recommended that preoperative vocal cord evaluation should be performed only in patients with severe symptoms, such as dyspnea.

Effects of antituberculosis treatment on self assessment, perceptual analysis and acoustic analysis of voice quality in laryngeal tuberculosis patients

2008 ◽  
Vol 122 (4) ◽  
pp. 378-382 ◽  
Author(s):  
K Yelken ◽  
M Guven ◽  
M Topak ◽  
E Gultekin ◽  
F Turan
Keyword(s):  
Acoustic Analysis ◽  
Voice Quality ◽  
Vocal Folds ◽  
Median Score ◽  
Self Assessment ◽  
Tuberculosis Patients ◽  
Perceptual Analysis ◽  
Antituberculosis Treatment ◽  
The Voice ◽  
Laryngeal Tuberculosis

AbstractObjectives:To evaluate the effects of antituberculosis treatment on the voice quality of laryngeal tuberculosis patients, measured by patient self-assessment, perceptual analysis and acoustic analysis.Materials and methods:A total of 14 laryngeal tuberculosis patients were enrolled. Laryngeal tuberculosis was established either by biopsy and histopathological examination or by rapid regression of the laryngeal lesions after antituberculosis medication. Before and after treatment, all patients were evaluated perceptually (on a scale of zero to three), and 12 assessed their own voices using the voice handicap index-10 scale. Acoustic analysis was performed to allow objective evaluation.Results:Patients' ages ranged from 21 to 72 years (mean, 41). The male to female ratio was 12:2. Eight patients (57 per cent) had tuberculous involvement of the epiglottis, four (28 per cent) had involvement of the aryepiglottic fold and eight (57 per cent) had involvement of the false vocal folds. The glottis was the less commonly involved part of the larynx, including true vocal folds (28 per cent, n = 4) and posterior commissure (14 per cent, n = 2). Perceptual evaluation, on a scale of zero to three, gave the patients a median score of six; after commencement of treatment, the median score decreased to two. The mean voice handicap index-10 score decreased from 24 to 12 after treatment. An obvious improvement in acoustic analytical parameters was also found following treatment.Conclusions:Antituberculosis treatment clearly improved the voice outcomes of laryngeal tuberculosis patients, according to self-assessment, perceptual analysis and acoustic analysis.

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

Surgery ◽  
2020 ◽  
Vol 167 (1) ◽  
pp. 129-136 ◽  
Author(s):  
Frédéric Borel ◽  
Christophe Tresallet ◽  
Antoine Hamy ◽  
Muriel Mathonnet ◽  
Jean-Christophe Lifante ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Multicenter Study ◽  
Voice Handicap Index ◽  
Self Assessment ◽  
Prospective Multicenter Study ◽  
The Voice

The Effects of Cigarette Smoking on Voice-Fundamental Frequency

1987 ◽  
Vol 97 (4) ◽  
pp. 376-380 ◽  
Author(s):  
Christopher H. Murphy ◽  
Philip C. Doyle
Keyword(s):  
Cigarette Smoking ◽  
Fundamental Frequency ◽  
Matched Control ◽  
Vocal Folds ◽  
Group Research ◽  
The Mean ◽  
Voice Fundamental Frequency ◽  
The Voice ◽  
Previous Group ◽  
Age And Sex

Previous group research has shown that the mean voice-fundamental frequency (F0) for individuals who smoke is lower than that of age- and sex-matched nonsmokers. It is believed that this reduction in F0 is a result of edema of the vocal folds caused by tobacco smoke. This study investigated F0 changes during smoking and no-smoking periods. Data were collected before, during, and after a 40-hour period of no-smoking. Analysis of the voice recordings showed a rise in voice F0 for the two smoking subjects during the 40-hour no-smoking period. Age- and sex-matched control subjects did not show a rise in their F0 during the same tasks. Results suggest that the pitch-lowering effects of cigarette smoking may be reversed after as few as 40 hours of smoking cessation.

scholarly journals Influence of Recurrent Laryngeal Nerve Transient Unilateral Palsy on Objective Voice Parameters and on Voice Handicap Index after Total Thyroidectomy (Including Thyroid Carcinoma)

2021 ◽  
Vol 18 (8) ◽  
pp. 4300
Author(s):  
Zuzana Veldova ◽  
Richard Holy ◽  
Jan Rotnagl ◽  
Temoore Younus ◽  
Jiri Hlozek ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Voice Quality ◽  
Laryngeal Nerve ◽  
Voice Handicap Index ◽  
Mean Values ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
The Voice

Introduction: Total thyroidectomy (TT) is one of the most common surgical endocrine surgeries. Voice impairment after TT can occur not only in patients with recurrent laryngeal nerve (RLN) transient paralysis, but also in cases of normal vocal cord mobility. Aim: To compare voice limits using a speech range profile (SRP) in patients before and 14 days after TT and to investigate the influence of the early results of voice quality after TT on the personal lives of patients. We focused on the perception of voice change before and shortly after TT. Materials and methods: A retrospective study, in the period 2018–2020, included 65 patients aged 22–75 years. We compared two groups of patients: group I (n = 45) (without RLN paresis) and group II (n = 20) (with early transient postoperative RLN paresis). Patients underwent video flexible laryngocopy, SRP, and Voice Handicap Index-30 (VHI-30). Results: In group I, the mean values of Fmax (maximum frequency) and Imax (maximum intensity) decreased in women (both p = 0.001), and VHI-30 increased (p = 0.001). In group II after TT in women, the mean Fmax and Imax values decreased (p = 0.005 and p = 0.034), and the frequency range of the voice was reduced from 5 to 2 semitones. The dynamic range of the voice was reduced by 3.4 dB in women and 5.1 dB in men.VHI-30 increased (p = 0.001). Conclusion: The study documented a worsening of the mean values of SRP, VHI-30, and voice parameters of patients in group II. Voice disorders also occurred in group I without RLN paresis. Non-paretic causes can also contribute to voice damage after TT. SRP and VHI-30 are suitable tools for comparing voice status in two groups of patients, including those with dysphonia. Our data support the claim that the diagnosis of a thyroid cancer does not necessarily imply a higher postoperative risk of impaired voice quality for the patient.

scholarly journals Patient Self-Assessment and Acoustic Voice Analysis in Screening of Postoperative Vocal Fold Paresis and Paralysis

2021 ◽  
pp. 145749692110070
Author(s):  
M. Heikkinen ◽  
E. Penttilä ◽  
M. Qvarnström ◽  
K. Mäkinen ◽  
H. Löppönen ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Voice Handicap Index ◽  
Index Score ◽  
Parathyroid Surgery ◽  
Voice Analysis ◽  
Self Assessment ◽  
Acoustic Voice Analysis ◽  
Vocal Fold Paresis ◽  
The Voice ◽  
Patient Self Assessment

Background and Aims: The aim of this study was to evaluate the utility of two items in vocal fold paresis and paralysis screening after thyroid and parathyroid surgery: patient self-assessment of voice using the Voice Handicap Index and computer-based acoustic voice analysis using the Multi-Dimensional Voice Program. Materials and Methods: This was a prospective study of 181 patients who underwent thyroid or parathyroid surgery over a 1-year study period (2017). Preoperatively, all patients underwent laryngoscopic vocal fold inspection and acoustic voice analysis, and they completed the Voice Handicap Index questionnaire. Postoperatively, all patients underwent laryngoscopy prior to hospital discharge; 2 weeks after the surgery, they completed the Voice Handicap Index questionnaire a second time. Two weeks postoperatively, patients with vocal fold paresis or paralysis and 20 randomly selected controls without vocal fold paresis or paralysis underwent a follow-up acoustic voice analysis. Results: Fourteen patients had a new postoperative vocal fold paresis or paralysis. Postoperatively, the total Voice Handicap Index score was significantly higher (p = 0.040) and the change between preoperative and postoperative scores was greater (p = 0.028) in vocal fold paresis or paralysis patients. A total postoperative Voice Handicap Index score > 30 had 55% sensitivity, and 90% specificity, for vocal fold paresis or paralysis. In the postoperative Multi-Dimensional Voice Program analysis, vocal fold paresis or paralysis patients had significantly more jitter (p = 0.044). Postoperative jitter > 1.33 corresponded to 55% sensitivity, and 95% specificity, for vocal fold paresis or paralysis. Conclusion: In identifying postoperative vocal fold paresis or paralysis, patient self-assessment and jitter in acoustic voice analysis have high specificity but poor sensitivity. Without routine laryngoscopy, approximately half of the patients with postoperative vocal fold paresis or paralysis could be overlooked. However, if the patient has no complaints of voice disturbance 2 weeks after thyroid or parathyroid surgery, the likelihood of vocal fold paresis or paralysis is low.

UPAYA MENINGKATKAN HASIL BELAJAR IPA MELALUI PENGGUNAAN VIDEO PEMBELAJARAN BAGI SISWA KELAS IV DI SDN 187/IV KOTA JAMBI

2015 ◽  
Vol 8 (2) ◽  
pp. 93
Author(s):  
Juniar Siregar
Keyword(s):  
Action Research ◽  
Research Method ◽  
Research Report ◽  
The Third ◽  
The Media ◽  
The Subject ◽  
The Mean ◽  
Classroom Action Research

This study presents a research report on improving students’ Learning results on IPA through Video. The objective was to find out whether students’ learning result improved when they are taught by using Video. It was conducted using classroom action research method. The subject of the study was the Grade IV students of SDN 187/IV Kota Jambi which is located on Jln. Adi Sucipto RT 05 Kecamatan Jambi Selatan, and the number of the students were 21 persons. The instruments used were test. In analyzing the data, the mean of the students’ score for the on fisrt sycle was 65,4 (42,85%) and the mean on cycle two was 68,5 (37,15%) and the mean of the third cycle was 81,4 (100%). Then it can be concluded that the use of video on learning IPA can improve the students’ learning result. It is suggested that teachers should use video as one of the media to improve students’ learning result on IPA.Keywords : IPA, students’ learning result, video

Sign in / Sign up

Export Citation Format

Share Document