title: [Influence of non-neuronal factors on post-thyroidectomy dysphonia].
abstract: OBJECTIVE
  We present a prospective study assessing the real incidence, aetiology, and evolution of vocal impairment following total thyroidectomy.
  
  
  METHODS
  Sixty-six patients who underwent total thyroidectomy between 2003 and 2006 were included, recording demographic and analytic variables, with emphasis on subjective vocal changes observed after surgery, measured by means of the GRABS scale. A control group of 25 patients operated under general anaesthesia and oro-tracheal intubation was chosen using random sampling.
  
  
  RESULTS
  In 30 patients (45.5 %), post-operative dysphonia was observed. Among these, only 2 (3 %) were permanent, and 11 were due to nerve damage (10 inferior and 1 superior laryngeal nerves). In 8 patients (12.2 %), GRABS score was above 5. In the rest of these 30 patients, the complaint was a single decreased tone (10 cases), lack of intensity (9 cases) and vocal fatigue (3 cases), always with a GRABS score equal to or less than 2 points. The most significantly related factor with the onset of dysphonia was the section of strap muscles (OR=12.5).
  
  
  CONCLUSIONS
  Dysphonia is a common complication of total thyroidectomy, but its incidence is not always related to nerve injury. Some technical (and sometimes avoidable) factors, such as the section of prelaryngeal muscles, could have an important relationship with this adverse event.
authors.affiliation: Servicio de Otorrinolaringología, Complejo Hospitalario Universitario de Badajoz, Badajoz, España. gtrinidad@gmail.com
authors.forename: Gabriel
authors.initials: G
authors.lastname: Trinidad Ruiz
authors.forename: Alicia
authors.initials: A
authors.lastname: González Palomino
authors.forename: Carlos
authors.initials: C
authors.lastname: Pantoja Hernández
authors.forename: Elena
authors.initials: E
authors.lastname: Mora Santos
authors.forename: Eduardo
authors.initials: E
authors.lastname: Cruz de la Piedad
authors.forename: Antonio
authors.initials: A
authors.lastname: Blasco Huelva
mesh_terms: D005260:Female; D006304:Health Status; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D012009:Recurrent Laryngeal Nerve / Q000502:physiology; D013965:Thyroidectomy; D014832:Voice Disorders / Q000209:etiology*