The Impact of Post-thyroidectomy Paresis on Quality of Life in Patients with Nodular Thyroid Disease

Jesper Roed Sorensen; Trine Printz; Jenny Iwarsson; Ågot Møller Grøntved; Helle Døssing; Laszlo Hegedüs; Steen Joop Bonnema; Christian Godballe; Camilla Sloth Mehlum

The Impact of Post-thyroidectomy Paresis on Quality of Life in Patients with Nodular Thyroid Disease

Jesper Roed Sorensen^*, Trine Printz, Jenny Iwarsson, Ågot Møller Grøntved, Helle Døssing, Laszlo Hegedüs, Steen Joop Bonnema, Christian Godballe, Camilla Sloth Mehlum

^*Corresponding author for this work

Department of Nordic Studies and Linguistics

4 Citations (Scopus)

Abstract

Objective: To investigate the impact of postoperative paresis on disease-specific quality of life (DSQoL) after thyroidectomy in patients with benign nodular thyroid disease. Study Design: Observational study. Setting: University hospital. Subjects and Methods: Patients were evaluated before and 3 weeks and 6 months after surgery in an individual prospective cohort study using videolaryngostroboscopy (VLS), voice range profile, voice handicap index (VHI), multidimensional voice program, maximum phonation time (MPT), and auditory perceptual evaluation. Changes in DSQoL were assessed by the Thyroid-specific Patient-Reported Outcome measure. Cohen’s effect size was used to evaluate changes. Results: Sixty-two patients were included, 55 of whom completed all examinations. Three weeks after surgery, a blinded VLS examination showed signs of paresis of either the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve (RLN/EBSLN) in 13 patients (24%). A paresis corresponded to a 12 ± 28 point increase in VHI (P =.002) and was associated with a significant 4.3 ± 7.5 semitone decrease in the maximum fundamental frequency (P <.001) and a 5.3 ± 8.2 dB reduction in maximum intensity. Further, it was associated with a 4.5 ± 11.2 second reduction in MPT (P =.001) and an increase of 0.40 ± 1.19 in grade, 0.42 ± 1.41 in roughness, and 0.36 ± 1.11 in breathiness. Signs of postoperative RLN/EBSLN paresis correlated with an 11.0-point (P =.02) poorer improvement in goiter symptoms at both 3 weeks and 6 months after surgery. Conclusion: Signs of RLN/EBSLN paresis after thyroidectomy were associated with less pronounced improvement in goiter symptoms in patients with thyroid nodular disease. However, thyroidectomy was associated with an overall improved DSQoL by 6 months after surgery.

Original language	English
Journal	Otolaryngology - Head and Neck Surgery
Pages (from-to)	1-9
Number of pages	9
ISSN	0194-5998
Publication status	Published - 1 Oct 2019

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@article{edc6b7c2074b48ea92aff6fd79766d57,

title = "The Impact of Post-thyroidectomy Paresis on Quality of Life in Patients with Nodular Thyroid Disease",

abstract = "Objective: To investigate the impact of postoperative paresis on disease-specific quality of life (DSQoL) after thyroidectomy in patients with benign nodular thyroid disease. Study Design: Observational study. Setting: University hospital. Subjects and Methods: Patients were evaluated before and 3 weeks and 6 months after surgery in an individual prospective cohort study using videolaryngostroboscopy (VLS), voice range profile, voice handicap index (VHI), multidimensional voice program, maximum phonation time (MPT), and auditory perceptual evaluation. Changes in DSQoL were assessed by the Thyroid-specific Patient-Reported Outcome measure. Cohen{\textquoteright}s effect size was used to evaluate changes. Results: Sixty-two patients were included, 55 of whom completed all examinations. Three weeks after surgery, a blinded VLS examination showed signs of paresis of either the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve (RLN/EBSLN) in 13 patients (24%). A paresis corresponded to a 12 ± 28 point increase in VHI (P =.002) and was associated with a significant 4.3 ± 7.5 semitone decrease in the maximum fundamental frequency (P <.001) and a 5.3 ± 8.2 dB reduction in maximum intensity. Further, it was associated with a 4.5 ± 11.2 second reduction in MPT (P =.001) and an increase of 0.40 ± 1.19 in grade, 0.42 ± 1.41 in roughness, and 0.36 ± 1.11 in breathiness. Signs of postoperative RLN/EBSLN paresis correlated with an 11.0-point (P =.02) poorer improvement in goiter symptoms at both 3 weeks and 6 months after surgery. Conclusion: Signs of RLN/EBSLN paresis after thyroidectomy were associated with less pronounced improvement in goiter symptoms in patients with thyroid nodular disease. However, thyroidectomy was associated with an overall improved DSQoL by 6 months after surgery.",

author = "Sorensen, {Jesper Roed} and Trine Printz and Jenny Iwarsson and Gr{\o}ntved, {{\AA}got M{\o}ller} and Helle D{\o}ssing and Laszlo Heged{\"u}s and Bonnema, {Steen Joop} and Christian Godballe and Mehlum, {Camilla Sloth}",

year = "2019",

month = oct,

day = "1",

language = "English",

pages = "1--9",

journal = "Otolaryngology - Head and Neck Surgery",

issn = "0194-5998",

publisher = "SAGE Publications",

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TY - JOUR

T1 - The Impact of Post-thyroidectomy Paresis on Quality of Life in Patients with Nodular Thyroid Disease

AU - Sorensen, Jesper Roed

AU - Printz, Trine

AU - Iwarsson, Jenny

AU - Grøntved, Ågot Møller

AU - Døssing, Helle

AU - Hegedüs, Laszlo

AU - Bonnema, Steen Joop

AU - Godballe, Christian

AU - Mehlum, Camilla Sloth

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Objective: To investigate the impact of postoperative paresis on disease-specific quality of life (DSQoL) after thyroidectomy in patients with benign nodular thyroid disease. Study Design: Observational study. Setting: University hospital. Subjects and Methods: Patients were evaluated before and 3 weeks and 6 months after surgery in an individual prospective cohort study using videolaryngostroboscopy (VLS), voice range profile, voice handicap index (VHI), multidimensional voice program, maximum phonation time (MPT), and auditory perceptual evaluation. Changes in DSQoL were assessed by the Thyroid-specific Patient-Reported Outcome measure. Cohen’s effect size was used to evaluate changes. Results: Sixty-two patients were included, 55 of whom completed all examinations. Three weeks after surgery, a blinded VLS examination showed signs of paresis of either the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve (RLN/EBSLN) in 13 patients (24%). A paresis corresponded to a 12 ± 28 point increase in VHI (P =.002) and was associated with a significant 4.3 ± 7.5 semitone decrease in the maximum fundamental frequency (P <.001) and a 5.3 ± 8.2 dB reduction in maximum intensity. Further, it was associated with a 4.5 ± 11.2 second reduction in MPT (P =.001) and an increase of 0.40 ± 1.19 in grade, 0.42 ± 1.41 in roughness, and 0.36 ± 1.11 in breathiness. Signs of postoperative RLN/EBSLN paresis correlated with an 11.0-point (P =.02) poorer improvement in goiter symptoms at both 3 weeks and 6 months after surgery. Conclusion: Signs of RLN/EBSLN paresis after thyroidectomy were associated with less pronounced improvement in goiter symptoms in patients with thyroid nodular disease. However, thyroidectomy was associated with an overall improved DSQoL by 6 months after surgery.

AB - Objective: To investigate the impact of postoperative paresis on disease-specific quality of life (DSQoL) after thyroidectomy in patients with benign nodular thyroid disease. Study Design: Observational study. Setting: University hospital. Subjects and Methods: Patients were evaluated before and 3 weeks and 6 months after surgery in an individual prospective cohort study using videolaryngostroboscopy (VLS), voice range profile, voice handicap index (VHI), multidimensional voice program, maximum phonation time (MPT), and auditory perceptual evaluation. Changes in DSQoL were assessed by the Thyroid-specific Patient-Reported Outcome measure. Cohen’s effect size was used to evaluate changes. Results: Sixty-two patients were included, 55 of whom completed all examinations. Three weeks after surgery, a blinded VLS examination showed signs of paresis of either the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve (RLN/EBSLN) in 13 patients (24%). A paresis corresponded to a 12 ± 28 point increase in VHI (P =.002) and was associated with a significant 4.3 ± 7.5 semitone decrease in the maximum fundamental frequency (P <.001) and a 5.3 ± 8.2 dB reduction in maximum intensity. Further, it was associated with a 4.5 ± 11.2 second reduction in MPT (P =.001) and an increase of 0.40 ± 1.19 in grade, 0.42 ± 1.41 in roughness, and 0.36 ± 1.11 in breathiness. Signs of postoperative RLN/EBSLN paresis correlated with an 11.0-point (P =.02) poorer improvement in goiter symptoms at both 3 weeks and 6 months after surgery. Conclusion: Signs of RLN/EBSLN paresis after thyroidectomy were associated with less pronounced improvement in goiter symptoms in patients with thyroid nodular disease. However, thyroidectomy was associated with an overall improved DSQoL by 6 months after surgery.

M3 - Journal article

SN - 0194-5998

SP - 1

EP - 9

JO - Otolaryngology - Head and Neck Surgery

JF - Otolaryngology - Head and Neck Surgery

ER -

The Impact of Post-thyroidectomy Paresis on Quality of Life in Patients with Nodular Thyroid Disease

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