Voice therapy should be offered to more thyroidectomy patients

Sep 5 2012

By Helen Albert, Senior medwireNews reporter

Voice problems following surgery to remove the thyroid gland are a common problem reported by patients, but only a minority are offered voice therapy, show results from a US study.

David Myssiorek (New York University) and colleagues reviewed data from the Thyroid Cancer Survivors' Association on patient-reported voice disturbance following thyroidectomy surgery in 4426 patients (37% of the total cohort).

Following exclusion of patients with preoperative voice disturbance or vocal fold immobility, post-thyroidectomy voice disorder (loss of loudness, vocal hoarseness) was reported by 51.1% of the 4426 patients after surgery. It was mostly temporary in nature, with 85.9% recovering full vocal function with time, but some patients reported permanent hoarseness.

Almost a quarter of patients with post-thyroidectomy voice disorder said that it was having a "detrimental impact on their professional or personal lives."

Voice therapy was only offered to 3.4% of those with voice problems following surgery, although it was generally successful with 73.7% of those given treatment reporting at least partial improvement.

The researchers recognize the limitations of their study due to its survey design. "Because involvement was voluntary, rates of post-thyroidectomy dysphonia may be overestimated, given the propensity for unhappy patients to participate," they explain in the Journal of Voice.

However, they say that their study provides important information for patients and physicians.

For example, "the discrepancy between rates of post-thyroidectomy voice disorder and its actual impact on patients' lives ought to reassure patients when counseled about postoperative dysphonia."

In addition, "among the hundreds of individuals who identified adverse effects on their personal and professional lives, the majority suffered temporary, rather than permanent, dysphonia," which should provide some comfort to patients due to undergo thyroidectomy, they say.

Voice therapy is currently underused in these patients, but the team says that the success in the small number of patients who were treated suggests that this could be an area for improvement in management of post-thyroidectomy dysphonia.

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