Assessment of Voice Outcomes Following Surgery for Thyroid Cancer

被引:29
作者
Kovatch, Kevin J. [1 ]
Reyes-Gastelum, David [2 ]
Hughes, David T. [3 ]
Hamilton, Ann S. [4 ]
Ward, Kevin C. [5 ]
Haymart, Megan R. [2 ]
机构
[1] Univ Michigan, Dept Otolaryngol Head & Neck Surg, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Div Metab Endocrinol & Diabet, North Campus Res Complex,2800 Plymouth Rd,Bldg16, Ann Arbor, MI 48109 USA
[3] Univ Michigan, Dept Surg, Div Endocrine Surg, Ann Arbor, MI 48109 USA
[4] Univ Southern Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA USA
[5] Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA 30322 USA
关键词
ASSOCIATION GUIDELINES; AMERICAN-COLLEGE; NECK DISSECTION; SURGICAL VOLUME; NERVE; PATIENT; COMPLICATIONS; VALIDATION; SUPERIOR; IMPACT;
D O I
10.1001/jamaoto.2019.1737
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Key PointsQuestionWhat is the association between thyroid cancer surgery and postoperative voice outcomes? FindingsIn this population-based study of 2325 patients aged 17 to 89 years diagnosed as having differentiated thyroid cancer, abnormal voice was noted in 272 patients following surgery for thyroid cancer. MeaningThese findings suggest a need for heightened awareness of voice abnormalities following surgery and warrant consideration in the preoperative risk-benefit discussion, planned extent of surgery, and postoperative rehabilitation. ImportanceAn increasing number of surgeries are being performed for differentiated thyroid cancer (DTC). Long-term voice abnormalities are a known risk of thyroid surgery; however, few studies have used validated scales to quantify voice outcomes after surgery. ObjectiveTo identify the prevalence, severity, and factors associated with poor voice outcomes following surgery for DTC. Design, Setting, and ParticipantsA cross-sectional, population-based survey was distributed via a modified Dillman method to 4185 eligible patients and linked to Surveillance, Epidemiology and End Results (SEER) data from SEER sites in Georgia and Los Angeles, California, from February 1, 2017, to October 31, 2018. Multivariable logistic regression and zero-inflated negative binomial analysis were performed to determine factors associated with abnormal voice. Participants included patients undergoing surgery for DTC between January 1, 2014, and December 31, 2015, excluding those with voice abnormalities before surgery. Main Outcomes and MeasuresAbnormal Voice Handicap Index (VHI-10) score, defined as greater than 11. The VHI-10 is designed to quantify 10 psychosocial consequences of voice disorders on a Likert scale (0, never; to 4, always). ResultsA total of 2632 patients (63%) responded to the survey and 2325 met the inclusion criteria. With data reported as unweighted number and weighted percentage, 1792 were women (77.4%); weighted mean (SD) age was 49.4 (14.4) years. Of these, 599 patients (25.8%) reported voice changes lasting more than 3 months following surgery, 272 patients (12.7%) were identified as having an abnormal VHI-10 score, and 105 patients (4.7%) reported vocal fold motion impairment diagnosed by laryngoscopy. In multivariable analysis, factors associated with an abnormal VHI-10 score included age 45 to 54 years (reference, <= 44 years; odds ratio [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 (OR, 1.67; 95% CI, 1.15-2.43), and lateral neck dissection (OR, 1.99; 95% CI, 1.11-3.56). Conclusions and RelevanceA high prevalence of abnormal voice per validation with the VHI-10 emphasizes the need for heightened awareness of voice abnormalities following surgery and warrants consideration in the preoperative risk-benefit discussion, planned extent of surgery, and postoperative rehabilitation. This cross-sectional survey study evaluates the outcomes of voice changes following surgery in patients with thyroid cancer.
引用
收藏
页码:823 / 829
页数:7
相关论文
共 45 条
[1]  
[Anonymous], 2009, SURVEY METHODOLOGY
[2]  
[Anonymous], STAND DEF FIN DISP C
[3]   Normative Values for the Voice Handicap Index-10 [J].
Arffa, Rachel E. ;
Krishna, Priya ;
Gartner-Schmidt, Jacqueline ;
Rosen, Clark A. .
JOURNAL OF VOICE, 2012, 26 (04) :462-465
[4]   Clinical Practice Guideline: Improving Voice Outcomes after Thyroid Surgery [J].
Chandrasekhar, Sujana S. ;
Randolph, Gregory W. ;
Seidman, Michael D. ;
Rosenfeld, Richard M. ;
Angelos, Peter ;
Barkmeier-Kraemer, Julie ;
Benninger, Michael S. ;
Blumin, Joel H. ;
Dennis, Gregory ;
Hanks, John ;
Haymart, Megan R. ;
Kloos, Richard T. ;
Seals, Brenda ;
Schreibstein, Jerry M. ;
Thomas, Mack A. ;
Waddington, Carolyn ;
Warren, Barbara ;
Robertson, Peter J. .
OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2013, 148 :S1-S37
[5]   Vocal Fold Paresis: Incidence, and the Relationship between Voice Handicap Index and Laryngeal EMG Findings [J].
Daggumati, Srihari ;
Panossian, Haig ;
Sataloff, Robert T. .
JOURNAL OF VOICE, 2019, 33 (06) :940-944
[6]   AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY DISEASE STATE CLINICAL REVIEW: THE INCREASING INCIDENCE OF THYRIOD CANCER [J].
Davies, Louise ;
Morris, Luc G. T. ;
Haymart, Megan ;
Chen, Amy Y. ;
Goldenberg, David ;
Morris, John ;
Ogilvie, Jennifer B. ;
Terris, David J. ;
Netterville, James ;
Wong, Richard J. ;
Randolph, Gregory .
ENDOCRINE PRACTICE, 2015, 21 (06) :686-696
[7]   Vocal Changes Following Thyroid Surgery: Prospective Study of Objective and Subjective Parameters [J].
Delgado-Vargas, Beatriz ;
Lloris Romero-Salazar, Tazucena ;
Cobeta, Ignacio .
JOURNAL OF VOICE, 2019, 33 (01) :27-32
[8]   Influence of neural monitoring during thyroid surgery on nerve integrity and postoperative vocal function [J].
Engelsman, A. F. ;
Warhurst, S. ;
Fraser, S. ;
Novakonic, D. ;
Sidhu, S. B. .
BJS OPEN, 2018, 2 (03) :135-141
[9]   Epidemiology of Vocal Fold Paralyses after Total Thyroidectomy for Well-Differentiated Thyroid Cancer in a Medicare Population [J].
Francis, David O. ;
Pearce, Elizabeth C. ;
Ni, Shenghua ;
Garrett, C. Gaelyn ;
Penson, David F. .
OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2014, 150 (04) :548-557
[10]   Psychometric evaluation of disease specific quality of life instruments in voice disorders [J].
Franic, DM ;
Bramlett, RE ;
Bothe, AC .
JOURNAL OF VOICE, 2005, 19 (02) :300-315