Kletzien H, et al. - Researchers sought to assess the quality-of-life consequences of postthyroidectomy voice change from the perspective of patients with thyroid cancer and to compare patient-perceived voice changes with changes in quantitative vocal variables at 5-time points in the first postoperative year. Out to at least 1 year of follow-up, voice changes were noted to be common after surgery for papillary thyroid cancer. These changes appeared affecting quality of life for many patients. For identifying patients whose quality of life has been affected by postthyroidectomy dysphonia, they suggested directly querying patients about postoperative voice changes and questioning whether commonly used aerodynamic and acoustic variables detect meaningful voice changes as significant.

Methods

• Researchers performed a prospective mixed methods observational study within a randomized clinical trial occurred at the University of Wisconsin Hospital and Clinics.
• This study included 42 patients with clinically node-negative papillary thyroid cancer without a preexisting vocal cord paralysis; these patients were recruited and enrolled from outpatient clinics between June 6, 2014, and March 6, 2017, as part of the ongoing randomized clinical trial.
• They undertook semistructured interviews, assessed symptom prevalence, and instrumental voice evaluations (laryngoscopy, phonation threshold pressure, Dysphonia Severity Index, and Voice Handicap Index) at baseline (n = 42) and 2-week (n = 42), 6-week (n = 39), 6-month (n = 35), and 1-year (n = 30) postoperative time points.

Results

• Mean age of the participants was 48 years (interquartile range, 38-58 years; age range, 22-70 years) and most of them were female (74% [31 of 42]) and were of white race/ethnicity (98% [41 of 42]).
• From patient interviews, impaired communication was the primary theme derived from before thyroidectomy to after thyroidectomy.
• Twenty-four participants percieved voice changes at 2 weeks after thyroidectomy.
• Voice symptoms were prevalent and persisted for 50% (21 of 42) of participants after surgery out to at least 1 year of follow-up.
• They detected quantitative vocal perturbations in the Dysphonia Severity Index and Voice Handicap Index at the 2-week follow-up but it returned to baseline levels by the 6-week follow-up visit.