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KMID : 0361020000430090985
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Korean Journal of Otolaryngology - Head and Neck Surgery
2000 Volume.43 No. 9 p.985 ~ p.991
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Voice Comparison between Strap Muscle Retraction and Cutting Technique in Thyroidectomy
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Kim Young-Mo
Cho Jung-Il
Kim Chul-Ho
Park Jung-Sun
Choi Ho-Soon
Ha Hyun-Roung
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Abstract
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Background and Objectives: A voice analysis was carried out before and after thyroid surgeries without laryngeal nerve injury, between strap muscle retraction and cutting group in thyroid surgery. The study was done by means of questionaires, acoustics and aerodynamic analysis.
Materials and Methods: A total of fourty-two patients of whom thirty-eight are females and four are males were analyzed ; hemithyroidectiomy (19 cases) and total thyroidectomy (23 cases). Twenty-seven patients had undergone thyroidectomy via retraction of strap muscle and 15 patients had undergone thyroidectomy via cutting of strap muscle. For evaluation of voice, questionaires for changes of voice, acoustics (fundamental frequency, jitter, shimmer, noise to harmonic ratio, voice intensity, vocal range), and aerodynamic(maximal phonation time, mean flow rate and subglottal pressure) analyses were done.
Results: The subjective voice symptoms after thyroidectomy were disturbances of high pitch, loud voice and singing voice, and easy fatigue at phonation. These voice symptoms were related to the extent of surgery. Vocal range was the only diminished parameter in acoustic and aerodynamic analyses after thyroidectomy. There were
significant differences in jitter on acoustic and aerodynamic analyses between the strap muscle retraction group and the cutting group.
Conclusion: Voice alteration after thyroidectomy without laryngeal nerve injury may be associated with the disturbance of the extralaryngeal skeleton-laryngotracheal fixation with impairment of vertical movement or by temporal malfunction of the strap muscles. These voice problems were related to the extent of surgery and cutting of strap muscles.
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KEYWORD
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Thyroidectomy, Strap muscle, Voice analysis
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