title: Changes of the speaking and singing voice after thyroid or parathyroid surgery.
abstract: BACKGROUND
  While permanent dysphonia is a rare complication of thyroid or parathyroid surgery, postoperative changes of the speaking and/or singing voice often remain unrecognized.
  
  
  METHODS
  In a prospective 4-arm study, vocal fold videolaryngostroboscopy and functional assessment of pre- and postoperative vocal performance was used to evaluate voice disturbances in 120 patients undergoing extended cervical surgery and in 19 patients with limited interventions for thyroid and/or parathyroid pathology.
  
  
  RESULTS
  Impairments, especially of the singing voice, were predominantly observed after extended endocrine neck surgery. In women, the highest pitch of the singing voice (HPS) dropped from 651 Hz to 563 Hz (E5 to Csharp5, P < .001). In men, the HPS decreased to a lesser extent (423 Hz to 374 Hz, (Gsharp4 to Fsharp4, P = .009). Covariant analysis of influencing factors revealed the preoperative maximum frequency range and the HPS as predictors of the postoperative voice outcome.
  
  
  CONCLUSIONS
  While alterations of the speaking voice after thyroid and parathyroid surgery usually remain subclinical, transient changes of the singing voice will matter to voice professionals.
authors.affiliation: Department of Endocrine Surgery, Gutenberg University Medical School, Mainz, Germany. thomas@musholt.com
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Musholt
authors.forename: Petra B
authors.initials: PB
authors.lastname: Musholt
authors.forename: Jens
authors.initials: J
authors.lastname: Garm
authors.forename: Ulrike
authors.initials: U
authors.lastname: Napiontek
authors.forename: Annerose
authors.initials: A
authors.lastname: Keilmann
mesh_terms: D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007828:Laryngoscopy; D008198:Lymph Nodes / Q000601:surgery; D008297:Male; D010280:Parathyroid Glands / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy / Q000009:adverse effects*; D011184:Postoperative Period; D011446:Prospective Studies; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D014741:Video Recording; D014827:Vocal Cords / Q000502:physiology; D014832:Voice Disorders / Q000209:etiology* / Q000503:physiopathology*; D014833:Voice Quality