Video-assisted thyroidectomy significantly reduces the risk of early postthyroidectomy voice and swallowing symptoms

Abstract
Background  Voice and swallowing symptoms are frequently reported after thyroidectomy even in absence of objective voice alterations.
We evaluated the influence of the video-assisted approach on voice and swallowing outcome of thyroidectomy.

Methods  Sixty-five patients undergoing total thyroidectomy (TT) were recruited. Eligibility criteria were: nodule size ≤30 mm, thyroid
volume ≤30 ml, no previous neck surgery. Exclusion criteria were: younger than aged 18 years and older than aged 75 years,
vocal fold paralysis, history of voice, laryngeal or pulmonary diseases, malignancy other than papillary thyroid carcinoma.
Patients were randomized for video-assisted (VAT) or conventional (CT) thyroidectomy. Videostrobolaryngoscopy (VSL), acoustic
voice analysis (AVA), and maximum phonation time (MPT) evaluation were performed preoperatively and 3 months after TT. Subjective
evaluation of voice (voice impairment score = VIS) and swallowing (swallowing impairment score = SIS) were obtained preoperatively,
1 week, 1 month, and 3 months after TT.

Results  Fifty-three patients completed the postoperative evaluation: 29 in the VAT group, and 24 in the CT group. No laryngeal nerves
injury was shown at postoperative VSL. Mean postoperative MPT, F
0, F
low, F
high, and the number of semitones were significantly reduced in the CT group but not in the VAT group. Mean VIS 3 months after
surgery was significantly higher than preoperatively in CT group but not in the VAT group. Mean SIS was significantly decreased
1 and 3 months after VAT but not after CT.

Conclusions  The incidence and the severity of early voice and swallowing postthyroidectomy symptoms are significantly reduced in patients
who undergo VAT compared with conventional surgery.

Content Type Journal ArticleDOI 10.1007/s00268-007-9443-2Authors
Celestino P. Lombardi, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli” Division of Endocrine Surgery, Department of Surgery L.go A. Gemelli 8 00168 Rome ItalyMarco Raffaelli, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli” Division of Endocrine Surgery, Department of Surgery L.go A. Gemelli 8 00168 Rome ItalyLucia D’alatri, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli” Institute of Otolaryngology L.go A. Gemelli 8 00168 Rome ItalyCarmela De Crea, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli” Division of Endocrine Surgery, Department of Surgery L.go A. Gemelli 8 00168 Rome ItalyMaria Raffaella Marchese, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli” Institute of Otolaryngology L.go A. Gemelli 8 00168 Rome ItalyDaria Maccora, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli” Division of Endocrine Surgery, Department of Surgery L.go A. Gemelli 8 00168 Rome ItalyGaetano Paludetti, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli” Institute of Otolaryngology L.go A. Gemelli 8 00168 Rome ItalyRocco Bellantone, Università Cattolica del Sacro Cuore, Policlinico “A. Gemelli” Division of Endocrine Surgery, Department of Surgery L.go A. Gemelli 8 00168 Rome Italy

Journal World Journal of SurgeryOnline ISSN 1432-2323Print ISSN 0364-2313 (Source: World Journal of Surgery)