Improving Voice Outcomes After Injury to the Recurrent Laryngeal Nerve
Objectives: The present study aimed to determine the voice outcomes before and after the administration of voice therapy in patients who suffered an injury to the recurrent laryngeal nerve after undergoing thyroidectomy. Methods: The sample consisted of 26 patients (2 males and 24 females) aged between 18 and 80 years (m=55±12) who experienced injury to the recurrent laryngeal nerve following thyroidectomy that was used to treat a thyroid gland disease. Subjective and objective parameters of the voice of the patients as well as its aerodynamic aspects were assessed upon the completion of the surgical procedure and before and after the implementation of voice therapy. Objective voice analysis was performed with the help of computer software viz. “Speech Training for Windows, Version 4.00 - Dr. Speech “and” EZ Voice Plus (TM) v. 2.0;” while GRBAS scale was used for subjective voice assessment. The subjects were followed for two years. The data so collected during this period was analyzed by implementing descriptive statistical parameters, Chi-square test, t-test and Wilcoxon test. Results: Patients with an injury to the recurrent laryngeal nerve were found to have voice alterations in all vocal parameters of subjective voice assessment conducted using the GRBAS Scale. These alterations ranged from moderate to severe degree, which provided a high degree of roughness in the voice. Objective voice assessment parameter analysis showed a decrease in voice pitch, increase in shimmer, decrease in noise-to-harmonics ratio, decrease in maximum phonation time and a decrease in voiceless percentage. Overall, it was observed that there were significant differences in all parameters of subjective and objective voice assessment, before and after vocal therapy, except for variables regarding the noise-to-harmonics ratio and aerodynamic variable of the S/Z ratio, although, the results on these vocal parameters were better after voice therapy. Discussion: Laryngeal symptoms are known to often accompany thyroidectomy procedures. In the present study, it was observed that administration of vocal therapy and teamwork between the doctors and speech therapist significantly affected the patient’s recovery and improvement in the quality of voice after thyroidectomy.
BACKGROUND Injury of the inferior laryngeal nerve is not the only cause of voice alteration after thyroidectomy; many patients notice minimal changes immediately after operation, without evidence of inferior laryngeal nerve damage. We hypothesized that there may be other causes for voice modification, such as injuries of the superior laryngeal nerve, prethyroid strap muscles, and cricothyroid m...متن کامل
OBJECTIVE To evaluate clinician perception of voice quality, patient self-reported psychosocial impact of dysphonia, and glottic closure in patients who have undergone resection of the recurrent laryngeal nerve (RLN) and immediate operative reconstruction during thyroid surgery. STUDY DESIGN Prospective observational study. SETTING Single tertiary care hospital. SUBJECTS AND METHODS Nine ...متن کامل
BACKGROUND Chest wall trauma is a frequent cause for emergency department presentations, with traumatic pneumathoraces a relatively common occurance. Vocal cord paralysis however, is uncommon. CASE REPORT A 44 year old man presented with a traumatic pneumothorax following a fall. A weak and hoarse voice was noted and vocal cord palsy demonstrated on indirect laryngoscopy. CT chest was unremar...متن کامل
Recurrent laryngeal nerve (RLN) injury is a feared complication after thyroid and parathyroid surgery. It induces important postoperative morbidity. The present study aimed to assess the incidence of transient/permanent postoperative RLN injuries after thyroid and parathyroid surgery in the present cohort, to observe the timing of recovery, and to identify risk factors for permanent RLN injury ...متن کامل
Comparison of the Frequency of Recurrent Laryngeal Nerve Injury with and without Exploration of the Nerve in Thyroidectomy
Background & Aims: Surgeons are not willing to participate in thyroid surgeries due to dangerous, although rare, complications of the procedure. Post thyroidectomy complications are divided in early and late onset; hypocalcemia, bleeding, thyroid storm and recurrent laryngeal nerve (RLN) injury are the most important ones. This study was performed to compare the frequency of recurrent laryngeal...متن کامل
OBJECTIVES Vocal cord paresis or paralysis due to iatrogenic injury of the recurrent laryngeal nerve (RLNI) is one of the main problems in thyroid surgery. Although many procedures have been introduced to prevent the nerve injury, still the incidence of recurrent laryngeal nerve palsy varies between 1.5-14%. The aim of the present study is to assess the risk factors of recurrent laryngeal nerve...متن کامل
دوره 15 شماره None
صفحات 399- 406
تاریخ انتشار 2017-11
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