Voice abnormalities common after surgery for thyroid cancer

  • Kovatch KJ & al.
  • JAMA Otolaryngol Head Neck Surg
  • 18 Jul 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • >25% of patients who received surgery for differentiated thyroid cancer (DTC) reported voice changes lasting >3 months.

Why this matters

  • Surgery is becoming more common for DTC, but few studies have analyzed voice outcomes using validated scales.

Key results

  • 25.8% of patients reported voice changes lasting >3 months after surgery.
  • 12.7% of patients had an abnormal score (>11) on the Voice Handicap Index (VHI-10).
  • 4.7% of patients reported vocal fold motion impairment (VFMI) diagnosed by laryngoscopy.
  • Age 45-54 years (OR, 1.49; 95% CI, 1.05-2.11), black race (OR, 1.73; 95% CI, 1.14-2.62), Asian race (OR, 1.66; 95% CI, 1.08-2.54), gastroesophageal reflux disease (GERD; OR, 1.67; 95% CI, 1.15-2.43), and lateral neck dissection (OR, 1.99; 95% CI, 1.11-3.56) were associated with abnormal VHI-10 score.
  • Age ≥45 years (OR, 2.26; 95% CI, 1.27-4.01 for age 45-64 years; OR, 1.96; 95% CI, 1.04-3.70 for age 55-64 years; OR, 2.11; 95% CI, 1.11-4.01 for age ≥65 years), black race (OR, 3.24; 95% CI, 1.83-5.72), GERD (OR, 1.91; 95% CI, 1.08-3.39), and tumor size >4.0 cm (OR, 2.44; 95% CI, 1.22-4.87) were associated with VFMI.

Study design

  • 2325 patients with DTC who underwent surgery were included.
  • Funding: National Cancer Institute, California Department of Public Health, CDC.

Limitations

  • Cross-sectional study.
  • Patient-reported data.