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A systematic review and meta‐analysis on acoustic voice parameters after uncomplicated thyroidectomy
Author(s) -
Lang Brian H. H.,
Wong Carlos K. H.,
Ma Estella P. M.
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25452
Subject(s) - medicine , thyroidectomy , jitter , recurrent laryngeal nerve , phonation , audiology , thyroid , electronic engineering , engineering
Background Postthyroidectomy voice changes are common even without apparent laryngeal nerve injury. Our study evaluated the impact of open cervical thyroidectomy on five acoustic voice parameters in the early (< 3 months) and late (≥ 3 months) postoperative periods. Methods A systematic review was performed to identify studies that quantitatively assessed voice quality by acoustic voice analysis before and after thyroidectomy. Parameters included average fundamental frequency (F 0 , Hz), jitter (%), shimmer (%), noise‐to‐harmonic ratio (NHR), and maximum phonation time (MPT) (in secs). Meta‐analysis was performed using both fixed‐ and random‐effects models. Results A total of 896 patients were analyzed. Relative to baseline, F 0 significantly worsened in the early period (from 194.9 ± 34.9 Hz to 188.0 ± 34.0 Hz, P = 0.001). This was equivalent to a quarter‐tone loss ( P = 0.004). Shimmer (from 3.15 ± 1.59% to 3.19 ± 1.70%, P = 0.040) and MPT (from 17.9 secs to 16.7 secs, P = 0.046) also worsened in the early period, whereas jitter and NHR remained unchanged in the early and late periods. Males suffered greater deterioration in F 0 (from 120.6 ± 18.8 Hz to 111.0 ± 18.5 Hz, P = 0.048) and in NHR (from 0.12 ± 0.02 to 0.16 ± 0.03, P = 0.019) than females in the early period. Four of the five acoustic parameters (F 0 , jitter, shimmer, and NHR) significantly worsened after total thyroidectomy (TT) and not after lesser resection. Conclusion F 0 , shimmer, and MPT significantly worsened in the early and not in the late postoperative period. F 0 impairment was perceptually significant. Males and those undergoing TT suffered greater voice impairment than their counterparts during the early period. Laryngoscope , 126:528–537, 2016