Subjective and objective screening measures for dysphonia pre-thyroidectomy

Abstract

There has been a link established between post-surgical dysphonia and thyroidectomy procedures and various studies identify that a large percentage of these patients have dysphonia after surgery. Most of these incidences of dysphonia resolve six months after the procedure, but there are reported cases of dysphonia that persists longer than six months and which are unrelated to any potential complications that could cause dysphonia. There may be a percentage of patients who present with dysphonia before surgery, which would indicate that the resilient dysphonia is related not to the surgery, but rather to their baseline vocal quality. The purpose of this study is to determine if there is a percentage of patients who are scheduled for thyroidectomies that have dysphonia and if there are any screening methods (subjective or objective) that surgeons may use to refer these potential cases of dysphonia for a full voice evaluation before the surgery. Eleven patients were included in this study. Each patient was a candidate for thyroidectomy and elected to have the procedure performed by Dr. Walter E. Pofahl, the cooperative surgeon for this study. For each patient, the following protocol was administered: background questions targeting factors that may indicate an increased risk of dysphonia, Voice Handicap Index, Consensus Auditory-Perceptual Evaluation of Voice, and Voice Evaluation Suite. This protocol was designed to measure present dysphonia subjectively, by gaining the patients' and the investigator's opinion of dysphonia, and objectively, through acoustic measurements. Graphical comparisons of the data revealed several "risk factors" surgeons could keep in mind and the CAPE-V may be a useful tool for pre-surgical referral.