Self-assessment of voice outcomes after total thyroidectomy using the Voice Handicap Index questionnaire: Results of a prospective multicenter study

Surgery. 2020 Jan;167(1):129-136. doi: 10.1016/j.surg.2019.05.090. Epub 2019 Sep 13.

Abstract

Background: Voice disorders are frequent after thyroidectomy. We report the long-term voice quality outcomes after thyroidectomy using the voice handicap index self-questionnaire.

Methods: Eight hundred patients who underwent total thyroidectomy between 2014 and 2017 in 7 French hospitals were prospectively included. All patients filled in voice handicap index questionnaires, preoperatively and 2 and 6 months after surgery.

Results: Median (range) voice handicap index scores were significantly increased at month 2 (4 [0; 108]) compared to preoperative values (2 [0; 76]) and were unchanged at month 6 (2 [2; 92]). Clinically significant voice impairment (voice handicap index score difference ≥18 points) was reported in 19.7% at month 2 and 13% at month 6. Thirty-seven (4.6%) had postoperative vocal cord palsy. In patients with vocal cord palsy compared to those without, median voice handicap index scores were increased at month 2 (14 [0; 107] vs 4 [0; 108]; P = .0039), but not at month 6 (5 [0; 92] vs 2 [0; 87]; P = .0702). Clinically significant impairment was reported in 38% vs 19% at month 2 (P = .010), and in 19% vs 13% at month 6 (P = .310). Thyroid weight, postoperative hypocalcemia, vocal cord palsy, and absence of intraoperative neuromonitoring utilization were associated with an increased risk of clinically significant self-perceived voice impairment at month 2.

Conclusion: Thyroidectomy impairs patients' voice quality perception in patients with and without vocal cord palsy.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / etiology
  • Postoperative Complications / psychology
  • Prospective Studies
  • Risk Factors
  • Self-Assessment*
  • Surveys and Questionnaires / statistics & numerical data
  • Thyroidectomy / adverse effects*
  • Vocal Cord Paralysis / diagnosis*
  • Vocal Cord Paralysis / etiology
  • Vocal Cord Paralysis / psychology
  • Voice Disorders / diagnosis*
  • Voice Disorders / etiology
  • Voice Disorders / psychology
  • Voice Quality