| Research background and purpose:In recent years,the incidence of thyroid disease has increased significantly,with thyroid carcinoma accounting for the majority.Surgery plays an important role in the treatment of thyroid cancer,the incidence of routine complications after surgery is decreasing,and changes in voice and swallowing function are currently one of the common complaints after thyroidectomy.However,there are few studies on the effect of thyroidectomy on voice and swallowing function,and in this study,we mainly focused on the changes and recovery of voice and swallowing function after thyroid surgery,and whether changes in postoperative voice and swallowing function were affected by the scope of surgical resection.This review comprehensively assessed changes in voice and swallowing function after surgery in different thyroidectomy ranges(partial thyroidectomy,total thyroidectomy).Materials and Methods:Patients who underwent thyroidectomy for the first time in the Department of Head and Neck Surgery of Sichuan Cancer Hospital in May and June 2022 and completed postoperative follow-up according to the time specified in the study were collected.They were divided into partial thyroidectomy group and total thyroidectomy group,and all completed the questionnaire surveys of the subjective voice handicap index(VHI)and swallowing impairment score(SIS)1 day before surgery,1 day after surgery,1 week after surgery,1 month after surgery,and half a year after surgery.In addition,Praat voice software was used to record the voice 1 day before,1 day after surgery and 1 month after surgery and perform objective acoustic speech analysis,and the analysis indicators mainly were:fundamental frequency(F0),fundamental frequency perturbation(jitter),amplitude perturbation(shimmer)and maximum pronunciation time(MPT).The SPSS software was used to analyze the general data,subjective and objective indicators of voice,and subjective and semi-subjective indicators of swallowing in both groups.Result:F0,Jitter,Shimmer and MPT were more severe than before surgery in the total resection group and partial resection group,among which MPT was statistically significant(~aP<0.05)in the total resection group and partial resection group,and the remaining indicators were only statistically significant in the total resection group.The F0 and MPT in the total resection group and the partial resection group were significantly better than those in the first day after surgery(~bP<0.05),and the improvement in Jitter in one month after surgery was only statistically significant in the total resection group(~bP<0.05).Jitter was higher in the total resection group than in the partial resection group(~gP<0.05).The subjective index of response to voice was significantly higher in the total resection group and partial resection group at 1 day after surgery,1 week after surgery and 1 month after surgery(all ~aP<0.05).The VHI in the total resection group and the partial resection group was significantly reduced(~cP<0.05,~dP<0.05)in half a year after surgery and one month after surgery,and the VHI in half a year after total resection was also significantly reduced(~bP<0.05)in half a year after surgery.The VHI was higher in the total resection group at one day after surgery,one week after surgery,and one month after surgery than in the partial resection group(~gP<0.05).The subjective index of responsive swallowing was significantly higher in the total resection group and the partial resection group at 1 day,1 week after surgery and 1 month after surgery(all ~aP<0.05).SIS in the total resection group and the partial resection group was significantly lower than that in the first half year after surgery,1 week after surgery and 1 month after surgery(~bP<0.05,c P<0.05,~dP<0.05).SIS in the total resection group was higher than in the partial resection group(~gP<0.05)at one week and one month after surgery,and the difference was statistically significant.The semi-subjective index of reaction to swallowing was significantly more severe than the preoperative swallowing cough(~aP<0.05)one day after surgery in the total resection group and the partial resection group,which was statistically significant.The total resection group and the partial resection group had significantly better coughing at one month after surgery and six months after surgery compared with one day after surgery(~bP<0.05).There were no significant differences between swallowing and choking cough between the total resection group and the partial resection group before surgery,one day after surgery,one week after surgery,one month after surgery,and half a year after surgery(P≥0.05).Conclusion:After thyroid surgery(total resection group and partial resection group),the voice quality and swallowing function of patients will decrease,and they can gradually return to normal at 1 month after surgery,and fully recover close to the preoperative level after half a year.As the extent of thyroidectomy increases,the sound quality and swallowing function decline more severely after surgery(especially one week after surgery and one month after surgery). |
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