Comparative analysis of voice outcomes between transoral endoscopic thyroidectomy vestibular approach (TOETVA) and transaxillary aprroach

  • Background: There have been a number of reports regarding the safety and utility of transoral endoscopic thyroidectomy vestibular approach (TOETVA), but nothing is known about voice dysfunction after such surgery. Therefore, this study was designed to assess functional voice outcomes after TOETVA and compare with preexisting remote access approach.

    Methods: The voice functional outcomes of 27 patients who underwent TOETVA and 58 patients after trans-axillary approach for hemithyroidectomy were analyzed. Thyroidectomy-related voice questionnaire (TVQ), auditory perceptual voice analysis, videolaryngostroboscopy and objective acoustic voice analysis were carried out before and 1 month after surgery. The changes in these values after the operation, and the differences between the TOETVA and trans-axillary groups were analyzed.

    Results: There was no significant changes in perceptual evaluation or TVQ score, nor in a number of parameters of acoustic voice analysis (fundamental frequency, shimmer, noise to harmonic ratio, pitch range), after surgery in TOETVA group. The value of perceptual evaluation, TVQ score, speech fundamental frequency (SFF) and shimmer were significantly changed in trans-axillary group. After surgery, clinically significant changes in voice pitch (?SFF > 12) were evident in 3 (11.1%) and 14 (24.1%) patients in the TOETVA and trans-axillary groups, respectively, and the group difference was not statistically significant (P=0.162).

    Conclusions: The results showed acceptable subjective and objective postoperative voice outcomes in patients undergoing TOETVA compared with preexisting remote access approach.

 

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