The Impact of Post-thyroidectomy Paresis on Quality of Life in Patients with Nodular Thyroid Disease

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Objective: To investigate the impact of postoperative paresis on disease-specific quality of life (DSQoL) after thyroidectomy in patients with benign nodular thyroid disease. Study Design: Observational study. Setting: University hospital. Subjects and Methods: Patients were evaluated before and 3 weeks and 6 months after surgery in an individual prospective cohort study using videolaryngostroboscopy (VLS), voice range profile, voice handicap index (VHI), multidimensional voice program, maximum phonation time (MPT), and auditory perceptual evaluation. Changes in DSQoL were assessed by the Thyroid-specific Patient-Reported Outcome measure. Cohen’s effect size was used to evaluate changes. Results: Sixty-two patients were included, 55 of whom completed all examinations. Three weeks after surgery, a blinded VLS examination showed signs of paresis of either the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve (RLN/EBSLN) in 13 patients (24%). A paresis corresponded to a 12 ± 28 point increase in VHI (P =.002) and was associated with a significant 4.3 ± 7.5 semitone decrease in the maximum fundamental frequency (P <.001) and a 5.3 ± 8.2 dB reduction in maximum intensity. Further, it was associated with a 4.5 ± 11.2 second reduction in MPT (P =.001) and an increase of 0.40 ± 1.19 in grade, 0.42 ± 1.41 in roughness, and 0.36 ± 1.11 in breathiness. Signs of postoperative RLN/EBSLN paresis correlated with an 11.0-point (P =.02) poorer improvement in goiter symptoms at both 3 weeks and 6 months after surgery. Conclusion: Signs of RLN/EBSLN paresis after thyroidectomy were associated with less pronounced improvement in goiter symptoms in patients with thyroid nodular disease. However, thyroidectomy was associated with an overall improved DSQoL by 6 months after surgery.

Original languageEnglish
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume161
Issue number4
Pages (from-to)589-597
ISSN0194-5998
DOIs
Publication statusPublished - Oct 2019

Fingerprint

Recurrent Laryngeal Nerve
Quality of Life
Phonation
Cohort Studies
Prospective Studies

Keywords

  • external branch of the superior laryngeal nerve
  • goiter
  • quality of life
  • recurrent laryngeal nerve
  • thyroidectomy
  • voice

Cite this

@article{ed3c7d87055345a986d817d56f0ff539,
title = "The Impact of Post-thyroidectomy Paresis on Quality of Life in Patients with Nodular Thyroid Disease",
abstract = "Objective: To investigate the impact of postoperative paresis on disease-specific quality of life (DSQoL) after thyroidectomy in patients with benign nodular thyroid disease. Study Design: Observational study. Setting: University hospital. Subjects and Methods: Patients were evaluated before and 3 weeks and 6 months after surgery in an individual prospective cohort study using videolaryngostroboscopy (VLS), voice range profile, voice handicap index (VHI), multidimensional voice program, maximum phonation time (MPT), and auditory perceptual evaluation. Changes in DSQoL were assessed by the Thyroid-specific Patient-Reported Outcome measure. Cohen’s effect size was used to evaluate changes. Results: Sixty-two patients were included, 55 of whom completed all examinations. Three weeks after surgery, a blinded VLS examination showed signs of paresis of either the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve (RLN/EBSLN) in 13 patients (24{\%}). A paresis corresponded to a 12 ± 28 point increase in VHI (P =.002) and was associated with a significant 4.3 ± 7.5 semitone decrease in the maximum fundamental frequency (P <.001) and a 5.3 ± 8.2 dB reduction in maximum intensity. Further, it was associated with a 4.5 ± 11.2 second reduction in MPT (P =.001) and an increase of 0.40 ± 1.19 in grade, 0.42 ± 1.41 in roughness, and 0.36 ± 1.11 in breathiness. Signs of postoperative RLN/EBSLN paresis correlated with an 11.0-point (P =.02) poorer improvement in goiter symptoms at both 3 weeks and 6 months after surgery. Conclusion: Signs of RLN/EBSLN paresis after thyroidectomy were associated with less pronounced improvement in goiter symptoms in patients with thyroid nodular disease. However, thyroidectomy was associated with an overall improved DSQoL by 6 months after surgery.",
keywords = "external branch of the superior laryngeal nerve, goiter, quality of life, recurrent laryngeal nerve, thyroidectomy, voice",
author = "Sorensen, {Jesper Roed} and Trine Printz and Jenny Iwarsson and Gr{\o}ntved, {{\AA}got M{\o}ller} and Helle D{\o}ssing and Laszlo Heged{\"u}s and Bonnema, {Steen Joop} and Christian Godballe and Mehlum, {Camilla Slot}",
year = "2019",
month = "10",
doi = "10.1177/0194599819855379",
language = "English",
volume = "161",
pages = "589--597",
journal = "Otolaryngology - Head and Neck Surgery",
issn = "0194-5998",
publisher = "SAGE Publications",
number = "4",

}

TY - JOUR

T1 - The Impact of Post-thyroidectomy Paresis on Quality of Life in Patients with Nodular Thyroid Disease

AU - Sorensen, Jesper Roed

AU - Printz, Trine

AU - Iwarsson, Jenny

AU - Grøntved, Ågot Møller

AU - Døssing, Helle

AU - Hegedüs, Laszlo

AU - Bonnema, Steen Joop

AU - Godballe, Christian

AU - Mehlum, Camilla Slot

PY - 2019/10

Y1 - 2019/10

N2 - Objective: To investigate the impact of postoperative paresis on disease-specific quality of life (DSQoL) after thyroidectomy in patients with benign nodular thyroid disease. Study Design: Observational study. Setting: University hospital. Subjects and Methods: Patients were evaluated before and 3 weeks and 6 months after surgery in an individual prospective cohort study using videolaryngostroboscopy (VLS), voice range profile, voice handicap index (VHI), multidimensional voice program, maximum phonation time (MPT), and auditory perceptual evaluation. Changes in DSQoL were assessed by the Thyroid-specific Patient-Reported Outcome measure. Cohen’s effect size was used to evaluate changes. Results: Sixty-two patients were included, 55 of whom completed all examinations. Three weeks after surgery, a blinded VLS examination showed signs of paresis of either the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve (RLN/EBSLN) in 13 patients (24%). A paresis corresponded to a 12 ± 28 point increase in VHI (P =.002) and was associated with a significant 4.3 ± 7.5 semitone decrease in the maximum fundamental frequency (P <.001) and a 5.3 ± 8.2 dB reduction in maximum intensity. Further, it was associated with a 4.5 ± 11.2 second reduction in MPT (P =.001) and an increase of 0.40 ± 1.19 in grade, 0.42 ± 1.41 in roughness, and 0.36 ± 1.11 in breathiness. Signs of postoperative RLN/EBSLN paresis correlated with an 11.0-point (P =.02) poorer improvement in goiter symptoms at both 3 weeks and 6 months after surgery. Conclusion: Signs of RLN/EBSLN paresis after thyroidectomy were associated with less pronounced improvement in goiter symptoms in patients with thyroid nodular disease. However, thyroidectomy was associated with an overall improved DSQoL by 6 months after surgery.

AB - Objective: To investigate the impact of postoperative paresis on disease-specific quality of life (DSQoL) after thyroidectomy in patients with benign nodular thyroid disease. Study Design: Observational study. Setting: University hospital. Subjects and Methods: Patients were evaluated before and 3 weeks and 6 months after surgery in an individual prospective cohort study using videolaryngostroboscopy (VLS), voice range profile, voice handicap index (VHI), multidimensional voice program, maximum phonation time (MPT), and auditory perceptual evaluation. Changes in DSQoL were assessed by the Thyroid-specific Patient-Reported Outcome measure. Cohen’s effect size was used to evaluate changes. Results: Sixty-two patients were included, 55 of whom completed all examinations. Three weeks after surgery, a blinded VLS examination showed signs of paresis of either the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve (RLN/EBSLN) in 13 patients (24%). A paresis corresponded to a 12 ± 28 point increase in VHI (P =.002) and was associated with a significant 4.3 ± 7.5 semitone decrease in the maximum fundamental frequency (P <.001) and a 5.3 ± 8.2 dB reduction in maximum intensity. Further, it was associated with a 4.5 ± 11.2 second reduction in MPT (P =.001) and an increase of 0.40 ± 1.19 in grade, 0.42 ± 1.41 in roughness, and 0.36 ± 1.11 in breathiness. Signs of postoperative RLN/EBSLN paresis correlated with an 11.0-point (P =.02) poorer improvement in goiter symptoms at both 3 weeks and 6 months after surgery. Conclusion: Signs of RLN/EBSLN paresis after thyroidectomy were associated with less pronounced improvement in goiter symptoms in patients with thyroid nodular disease. However, thyroidectomy was associated with an overall improved DSQoL by 6 months after surgery.

KW - external branch of the superior laryngeal nerve

KW - goiter

KW - quality of life

KW - recurrent laryngeal nerve

KW - thyroidectomy

KW - voice

U2 - 10.1177/0194599819855379

DO - 10.1177/0194599819855379

M3 - Journal article

VL - 161

SP - 589

EP - 597

JO - Otolaryngology - Head and Neck Surgery

JF - Otolaryngology - Head and Neck Surgery

SN - 0194-5998

IS - 4

ER -