title: Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuries.
abstract: BACKGROUND
  We performed a prospective analysis on voice and swallowing alterations following total thyroidectomy (TT), in the absence of recurrent nerve injury.
  
  
  METHODS
  Patients aged 21 to 65 years undergoing TT, in the absence of laryngeal/pulmonary disease, previous neck surgery, or malignant diseases, were subjected to videostrobolaryngoscopy (VSL), acoustic voice analysis (AVA), and maximum phonation time (MPT) tests preoperatively and 3 months postoperatively. Voice impairment scores (VIS) and swallowing impairment scores (SIS) were obtained preoperatively, and at 1 week, 1 month, and 3 months postoperatively.
  
  
  RESULTS
  Among the 127 selected patients, 39 completed the postoperative evaluation. No recurrent nerve injury was observed during the postoperative VSL in any of the patients. Preoperative and postoperative AVA and MPT scores did not differ significantly. The mean postoperative VIS was significantly higher than the preoperative VIS at 1 week and 1 month after TT (13.7 and 9.6 vs 4.4, respectively; P < .05) but not 3 months after TT (6.7). The mean SIS was higher than the preoperative SIS at 1 week, 1 month, and 3 months after TT (10.3, 6.0, and 2.8 vs 0.5, respectively; P < .05).
  
  
  CONCLUSIONS
  Physicians should inform patients that transient voice and swallowing symptoms may occur following total thyroidectomy, and our data suggest mild symptoms may occur in the majority of operated patients.
authors.affiliation: Division of Endocrine Surgery, Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Celestino Pio
authors.initials: CP
authors.lastname: Lombardi
authors.forename: Marco
authors.initials: M
authors.lastname: Raffaelli
authors.forename: Lucia
authors.initials: L
authors.lastname: D'Alatri
authors.forename: Maria Raffaella
authors.initials: MR
authors.lastname: Marchese
authors.forename: Mario
authors.initials: M
authors.lastname: Rigante
authors.forename: Gaetano
authors.initials: G
authors.lastname: Paludetti
authors.forename: Rocco
authors.initials: R
authors.lastname: Bellantone
mesh_terms: D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D061224:Laryngeal Nerve Injuries; D007823:Laryngeal Nerves / Q000503:physiopathology; D007828:Laryngoscopy; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D013061:Speech Acoustics; D011795:Surveys and Questionnaires; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods; D014741:Video Recording; D014832:Voice Disorders / Q000209:etiology*; D014833:Voice Quality