Translation, Cross-Cultural Adaptation and Preliminary Validation of the Thyroidectomy-Related Voice and Symptom Questionnaire (TVSQ) into Persian

Mehran Choubineh; Atena Bafetrat; Niloofar Nikpoor; Seyed Ahmad Fanaei; Banafshe Mansuri; Mozhgan Asadi; Seyed Abolfazl Tohidast

doi:10.1016/j.jvoice.2025.10.042

Translation, Cross-Cultural Adaptation and Preliminary Validation of the Thyroidectomy-Related Voice and Symptom Questionnaire (TVSQ) into Persian

J Voice. 2025 Nov 19:S0892-1997(25)00465-5. doi: 10.1016/j.jvoice.2025.10.042. Online ahead of print.

Authors

Mehran Choubineh¹, Atena Bafetrat², Niloofar Nikpoor³, Seyed Ahmad Fanaei⁴, Banafshe Mansuri⁵, Mozhgan Asadi⁶, Seyed Abolfazl Tohidast⁷

Affiliations

¹ Neuromuscular Rehabilitation Research Center, Research Institute of Neurosciences, Semnan University of Medical Sciences, Semnan, Iran. Electronic address: mehran_choubineh@yahoo.com.
² Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran. Electronic address: s.bafetrat.slp@gmail.com.
³ Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran. Electronic address: niloofar.nikpoor@yahoo.com.
⁴ Erfan Hospital, Tehran, Iran. Electronic address: info@ahmadfanaei.com.
⁵ Neuromuscular Rehabilitation Research Center, Research Institute of Neurosciences, Semnan University of Medical Sciences, Semnan, Iran. Electronic address: slp.banafshe@gmail.com.
⁶ Department of Speech Therapy, School of Rehabilitation Sciences, Semnan University of Medical Sciences, Semnan, Iran. Electronic address: mozhgan.asadist@yahoo.com.
⁷ Neuromuscular Rehabilitation Research Center, Research Institute of Neurosciences, Semnan University of Medical Sciences, Semnan, Iran. Electronic address: slp.tohidast@gmail.com.

PMID: 41266170
DOI: 10.1016/j.jvoice.2025.10.042

Abstract

Objectives: The present study aimed to translate, culturally adapt, and preliminarily validate the Persian version of the thyroidectomy-related voice and symptom questionnaire (TVSQ), a condition-specific patient-reported outcome measure assessing postoperative voice changes and throat-neck discomfort.

Methods: Following standardized cross-cultural adaptation protocols, the TVSQ was translated into Persian and administered to 150 participants evenly divided into three groups: post-thyroidectomy patients, individuals with laryngeal disorders, and healthy controls. Concurrent validity was examined through correlation analysis with the voice handicap index (VHI) and vocal tract discomfort scale (VTD). Discriminant validity was established by comparing scores across the three mentioned groups. Internal consistency was evaluated using Cronbach's alpha based on data from the post-thyroidectomy group. Test-retest reliability was assessed in a subset of 22 participants from the same group. Responsiveness to change was evaluated through pre and post-thyroidectomy score comparisons.

Results: Concurrent validity was supported by statistically significant correlations between the Persian TVSQ and established instruments: moderate association with the VHI (r = 0.374) and strong association with the VTD (r = 0.633). Discriminant validity analysis revealed significantly elevated scores in the post-thyroidectomy and laryngeal disorder groups compared to healthy controls (P < 0.001), confirming the tool's sensitivity to clinical symptom burden. Internal consistency was excellent for the total scale (α = 0.939) and subscales (α = 0.946 for "voice change" and α = 0.875 for "throat and neck discomfort"), while test-retest reliability also demonstrated good results (intraclass correlation coefficient = 0.83). The instrument proved responsive to clinical change, with scores increasing significantly two weeks after thyroidectomy compared to preoperative assessments, capturing both vocal and physical symptom changes.

Conclusion: The Persian version of the TVSQ is a valid, reliable, and culturally appropriate tool for assessing voice and throat-neck symptoms following thyroidectomy. Its cross-cultural adaptation facilitates improved patient-centered evaluation in Persian-speaking populations.

Keywords: Cross-cultural adaptation; Reliability; Throat and neck discomfort; Thyroidectomy; Validity; Voice disorders.