title: Voice and vocal self-assessment after thyroidectomy.
abstract: BACKGROUND
  Voice alterations after thyroidectomy can be found even with preserved function of laryngeal nerves. The purpose of this study was to evaluate voice before and after thyroid surgery and the role of orotracheal intubation on voice changes.
  
  
  METHODS
  We conducted a prospective nonrandomized study of patients who underwent thyroid surgery and compared the results with a control group of patients who underwent breast surgery. Subjects underwent a videolaryngoscopic exam, a subjective and an objective voice analysis and a Voice Handicap Index (VHI) questionnaire before and after surgery.
  
  
  RESULTS
  A total of 100 patients who underwent thyroidectomy and 30 who underwent breast surgery were studied. Both groups were similar in demographic, clinical, and surgical variables. Postoperative videolaryngoscopy showed larynx alterations in 28% of the thyroidectomized patients, without significant alterations in the control group. There were subjective voice changes in 29.7% of the patients without vocal fold immobility after thyroid surgery and no statistically significant changes after breast surgery. Acoustic analysis showed significant increased values in the voice turbulence index (VTI) parameter in both groups, although higher in the thyroid one. In the VHI assessment, voice complaints were more frequently registered in the thyroid group rather than in the control group.
  
  
  CONCLUSIONS
  Voice alterations are frequent after thyroidectomy even with preserved vocal fold mobility. Such alterations were more frequently detected in that group than in patients who underwent breast surgery. Orotracheal intubation is just one of the multiple factors involved.
authors.affiliation: Department of Voice, Speech and Swallowing Rehabilitation, Centro de Tratamento e Pesquisa Hospital do Câncer A.C.Camargo, São Paulo, Brazil.
authors.forename: Irene
authors.initials: I
authors.lastname: de Pedro Netto
authors.forename: Aline
authors.initials: A
authors.lastname: Fae
authors.forename: José Guilherme
authors.initials: JG
authors.lastname: Vartanian
authors.forename: Ana Paula Brandão
authors.initials: AP
authors.lastname: Barros
authors.forename: Luiz Maurício
authors.initials: LM
authors.lastname: Correia
authors.forename: Ronaldo Nunes
authors.initials: RN
authors.lastname: Toledo
authors.forename: José Ricardo Gurgel
authors.initials: JR
authors.lastname: Testa
authors.forename: Inês Nobuko
authors.initials: IN
authors.lastname: Nishimoto
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
authors.forename: Elisabete
authors.initials: E
authors.lastname: Carrara-de Angelis
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007828:Laryngoscopy; D007830:Larynx / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012647:Self-Assessment; D013959:Thyroid Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D014741:Video Recording; D014827:Vocal Cords / Q000473:pathology / Q000503:physiopathology; D014832:Voice Disorders / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology