Voice and swallowing symptoms after thyroid surgery assessed using the ThyVoice online platform.

IF 3.5 2区医学 Q2 ENDOCRINOLOGY & METABOLISM European Thyroid Journal Pub Date : 2023-08-01 DOI:10.1530/ETJ-23-0008

Radu Mihai

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Abstract

Objective: The aim of this multicentre study was to investigate the progression of patient-reported outcomes after thyroid surgery, with emphasis on voice and swallowing difficulties.

Methods: An online platform was used to collect replies to standardised questionnaires (voice handicap index, VHI; voice-related quality of life, VrQoL; EAT-10) preoperatively and at 2-6 weeks and 3-6-12 months after surgery.

Results: A total of 236 patients were recruited from five centres that contributed with median of 11 cases (range 2-186 cases). Average symptoms scores showed voice changes lasting up to 3 months: VHI increased from 41 ± 15 (preop) to 48 ± 21 (6 weeks) and returned to 41 ± 15 at 6 months. Similarly, VrQoL increased from 12 ± 4 to 15 ± 6 and returned to 12 ± 4 (6 months). Severe voice changes (VHI > 60) were reported in 12% of patients preop, 22% at 2 weeks, 18% at 6 weeks, 13% at 3 months and 7% at 12 months. Only five patients with normal preoperative voice had persistent severe voice changes after 6-12 months. Those with severe voice changes at 2 weeks (median VHI 70.5, IQR 65-81) had significant improvement by 6 months (median VHI 54, IQR 39-65) (P < 0.001). Swallowing assessment showed a median preop score of 0 (IQR 0-3) increasing to a median of 2 (IQR 0-8) at 2 weeks and normal values afterwards.

Conclusion: The ThyVoice online platform allows the assessment of patient-reported outcome measures in thyroid surgery. Voice morbidity appears to be more frequent than commonly reported, and this risk should the quoted during informed consent. Swallowing difficulties are mild but significant in the first 2 weeks.

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使用ThyVoice在线平台评估甲状腺手术后的声音和吞咽症状。

目的:本多中心研究的目的是调查甲状腺手术后患者报告的预后进展，重点是声音和吞咽困难。方法:采用在线平台收集标准化问卷(语音障碍指数，VHI;语音相关生活质量，VrQoL;术前、术后2-6周和3-6-12个月时的EAT-10)。结果:共从5个中心招募了236例患者，中位数为11例(范围2-186例)。平均症状评分显示声音变化持续时间长达3个月:VHI从术前的41±15增加到48±21(6周)，6个月时又恢复到41±15。VrQoL从12±4增加到15±6，再恢复到12±4(6个月)。术前有12%的患者报告了严重的声音改变(VHI > 60)， 2周时为22%，6周时为18%，3个月时为13%，12个月时为7%。只有5例术前声音正常的患者在6-12个月后出现持续严重的声音改变。2周时嗓音变化严重的患者(中位VHI为70.5,IQR为65-81)在6个月时有显著改善(中位VHI为54,IQR为39-65)(P < 0.001)。吞咽评估显示术前评分中位数为0 (IQR 0-3)，在2周时增加到中位数2 (IQR 0-8)，之后恢复正常。结论:ThyVoice在线平台可以评估甲状腺手术中患者报告的结果。声音发病率似乎比通常报道的更频繁，这一风险应在知情同意期间引用。吞咽困难是轻微的，但在前两周很明显。

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来源期刊

European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.70

自引率

2.10%

发文量

156

期刊介绍： The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.