Introduction: Voice disorders are a well-known complication which is often associated with thyroid gland diseases and because voice is still the basic mean of communication it is very important to maintain its quality healthy.

Objectives: The aim of this study referred to questions whether there is a statistically significant difference between results of voice self-assessment, perceptual voice assessment and acoustic voice analysis before and after thyroidectomy and whether there are statistically significant correlations between variables of voice self-assessment, perceptual assessment and acoustic analysis before and after thyroidectomy.

Methods: This scientific research included 12 participants aged between 41 and 76. Voice self-assessment was conducted with the help of Croatian version of Voice Handicap Index (VHI). Recorded reading samples were used for perceptual assessment and later evaluated by two clinical speech and language therapists. Recorded samples of phonation were used for acoustic analysis which was conducted with the help of acoustic program Praat. All of the data was processed through descriptive statistics and nonparametric statistical methods. 

Results: Results showed that there are statistically significant differences between results of voice self-assessments and results of acoustic analysis before and after thyroidectomy. Statistically significant correlations were found between variables of perceptual assessment and acoustic analysis.

Conclusion: Obtained results indicate the importance of multidimensional, preoperative and postoperative assessment. This kind of assessment allows the clinician to describe all of the voice features and provides appropriate recommendation for further rehabilitation to the patient in order to optimize voice outcomes.


voice quality; thyroidectomy; voice self-assessment; perceptual voice assessment; acoustic voice analysis

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Chandrasekhar SS, Randolph GW, Seidman MD, Rosenfeld RM, Angelos P, Barkmeier-Kraemer J, Benninger MS, Blumin JH, Dennis G, Hanks J, Haymart MR, Kloos RT, Seals B, Schreibstein JM, Thomas MA, Waddington C, Warren B, Robertson PJ. Clinical Practice Guideline: Improving Voice Outcomes after Thyroid Surgery. Otolaryngology - Head and Neck Surgery 2013; 148: 1–37.

Ozbas S, Kocak S, Aydintug S, Cakmak A, Demirkiran MA, Wishart GC. Comparison of the complications of subtotal, near total and total thyroidectomy in the surgical management of multinodular goitre. Endocrine Journal – Tokyo 2005; 52: 199–206.

Bergenfelz A, Jansson S, Kristoffersson A, Mårtensson H, Reihnér E, Wallin G, Lausen I. Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients. Langenbeck's Archives of Surgery 2008; 393: 667–673.

Stojadinovic A, Shaha AR, Orlikoff RF, Nissan A, Kornak MF, Singh B, Boyle JO, Shah JP, Brennan MF, Kraus DH. Prospective functional voice assessment in patients undergoing thyroid surgery. Annals of surgery 2002; 236 (6): 823–832.

Birkent H, Karacalioglu O, Merati AL, Akcam T, Gerek M. Prospective Study of the Impact of Thyroid Hormone Replacement on Objective Voice Parameters. Annals of Otology, Rhinology & Laryngology 2008; 117 (7): 523–527.

McIvor NP, Flint DJ, Gillibrand J, Morton RP. Thyroid surgery and voice-related outcomes. Australian and New Zeland Journal of Surgery 2000; 70: 179–183.

Finck C. Laryngeal Dysfunction After Thyroid Surgery: Diagnosis, Evaluation and Treatment. Acta Chirurgica Belgica 2006; 106: 378–387.

Hayward NJ, Grodski S, Yeung M, Johnson WR, Serpell J. Recurrent laryngeal nerve injury in thyroid surgery: a review. ANZ Journal of Surgery 2012; 83 (2013): 15–21.

Hermann M, Alk G, Roka R, Glaser K, Freissmuth M. Laryngeal Recurrent Nerve Injury in Surgery for Benign Thyroid Diseases Effect of Nerve Dissection and Impact of Individual Surgeon in More Than 27,000 Nerves at Risk. Annals of Surgery 2002; 235 (2): 261–268.

Soylu L, Ozbas S, Uslu HY, Kocak S. The evaluation of the causes of subjective voice disturbances after thyroid surgery. The American Journal of Surgery 2006; 194: 317–322.

Lo CY, Kwok KF, Yuen PW. A prospective eva¬lua¬tion of Recurrent laryngeal nerve paralysis du¬ring thyroidectomy. Surgery 2000; 135: 204–207.

Roy N, Smith ME, Houtz DR. Laryngeal Features of External Superior Laryngeal Nerve Denervation: Revisiting a Century-Old Controversy. Annals of Otology, Rhinology & Laryngology 2011; 120 (1): 1–8.

Santosh M, Rajashekhar B. Perceptual and Acoustic Analysis of Voice in Individuals with Total Thyriodectomy: Pre-Post Surgery Comparison. Indian Journal of Otolaryngology and Head and Neck Surgery 2011; 63 (1): 32–39.

Sinagra DL, Montesinos MR, Tacchi VA, Moreno JC, Falco JE, Mezzadri NA, Debonis DL, Curutchet HP. Voice changes after thyroidectomy without recurrent laryngeal nerve injury. Journal of the American College of Surgeons 2004; 199 (4): 556–560.

Rosato L, Avenia N, Bernante P, De Palma M, Gulino G, Nasi PG, Pelizzo MR, Pezzullo L. Complications of Tyroid Surgery: Analysis of Multicentric Study on 14, 943 Patients Operated in Italy over 5 Years. World Journal of Surgery 2004; 8: 271–276.

Dionigi G, Boni L, Rovera F, Rausei S, Castelnuovo P, Dionigi R. Postoperative laryngoscopy in thyroid surgery: proper timing to detect recurrent laryngeal nerve injury. Langenbeck's Archives of Surgery 2010; 395 (4): 327–331.

Rohde SL, Wright CT, Muckala JC, Wiggleton J, Rousseau B, Netterville JL. Voice quality after recurrent laryngeal nerve resection and immediate reconstruction. Otolaryngology - Head and Neck Surgery 2012; 147 (4): 733–736.

Boone DR, McFarlane SC. Voice and Voice Therapy. 6th edition. Allyn&Bacon: A Pearson Edu. Co., 2000.

Bonetti A, Bonetti L. Cross-Cultural Adaptation and Validation of the Voice Handicap Index Into Croatian. Journal of Voice 2013; 27: 7–14.

Boersma P, Weenink D. Praat: doing phonetics by computer. 2013. Available form: URL: http://www.fon.hum.uva.nl/praat.

Kuhn MA, Bloom G, Myssiorek D. Patient Perspectives on Dysphonia After Thyroidectomy for Thyroid Cancer. Journal of Voice 2012; 27: 111–114.

Bonetti A. Perceptivna procjena glasa. Hrvatska revija za rehabilitacijska istraživanja 2010; 47: 64–71.

Jakelić A, Bonetti A, Šimunjak B. Akustička procjena i samoprocjena glasa žena s bolestima štitnjače. Logopedija 2015; 5 (1): 9–14.

Page C, Zaatar R, Biet A, Strunski V. Subjective voice assessment after thyroid surgery: A prospective study of 395 patients. Indian Journal of Medical Sciences 2007; 61 (8): 448–454.

Yu P, Ouakninea M, Revisa J, Giovannia A. Objective Voice Analysis for Dysphonic Patients: A Multiparametric Protocol Including Acoustic and Aerodynamic Measurements. Journal of Voice 2001; 15 (4): 529–542.

DOI: http://dx.doi.org/10.19057/јser.2016.3

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