2018 Section 6 - Laryngology, Voice Disorders, and Bronchoesophalogy

S.-K.

Baek et

al.

/ Auris

Nasus

Larynx

44

(2017)

583 – 589

Table

2

of

the

pre-

and

postoperative Multi-Dimensional Voice

Program

(MDVP).

Results

1 week

PO

1 month

PO

3 months

p -Value

Preoperative

PO

Hemithyroidectomy F0

Group A Group B Group A Group B Group A Group B Group A Group B Group C Group D Group C Group D Group C Group D Group C Group D

209.2 211.5

5.6 3.9 0.1 0.1 0.1 0.1 0.0 0.0 4.5 3.1 0.1 0.1 1.2 0.1 0.0 0.0

202.2 183.9

7.3 7.1 0.1 0.1 0.2 0.2 0.0 0.0

201.6 179.0

7.3 7.9 0.1 0.1 0.3 0.3 0.0 0.0 6.3 5.5 0.2 0.1 0.6 0.1 0.0 0.0

201.8 186.9

6.9 7.4 0.2 0.1 0.4 0.4 0.0 0.0 6.9 5.2 0.1 0.1 0.2 0.1 0.0 0.0

0.9

0.75 0.75 2.97 2.72 0.12 0.12

0.87 0.87 2.82 2.74 0.13 0.12

0.92 0.87 2.96 2.86 0.13 0.12

1.02 0.87 3.09 3.11 0.14 0.12

0.41

Jitter

0.61

Shimmer

0.12

NHR

thyroidectomy

Total

213.2 203.4

204.9

7.6

197.2 167.1

203.1 176.9

< 0.01

F0

171.8

5.37

0.80 0.88 3.01 2.73 0.12 0.12

1.15 0.97 3.47 2.94 0.14 0.14

0.2 0.1 0.6 0.2 0.0 0.0

1.00 0.85 3.43 2.86 0.14 0.13

0.73 0.91 2.76 2.73 0.12 0.12

0.86

Jitter

0.16

Shimmer

0.15

NHR

fundamental

frequency; NHR = noise

harmonic

ratio;

PO = postoperative; Group A

and

C =

IONM

group; Group B

and D = non-IONM

group.

F0 =

maximum

In addition,

the changes

in F0 values ( D F0) at 1week, 1month,

pitch

showed

a

gradual

decrease

at

1

week

and

the preoperative values

month

after

operation

and

showed

recovery

at

3

months,

and 3months after surgery compared with were measured and compared between the

1

two groups. All of

the and

group C

showed

a

smaller

decrease

in

the maximum

whereas

D F0 then

showed tended

a

gradual

increase

until

1 month

after

surgery

pitch

value

compared

with

group

D.

An

ANOVA

test

vocal

showed

to

recover

irrespective

of

the

use

of

IONM.

a

significant

difference

in maximum

pitch

across

time

the D F0 values were higher

in groups B and D

(no-

between

group

C

and

D In

only

in

total

thyroidectomy

Furthermore, IONM groups)

points

irrespective of

the

extent of

surgery.

In

the

early

( p = 0.02)

( Table

4 ).

addition,

the

changes

in

the

patients

after

surgery

(postoperative

1 week),

even

if

hemithyr-

pitch

value

( D Maximum

pitch)

at

1 week,

1 month,

period

maximum

patients

did

not

show

any

significant

difference

in D

3

months

after

surgery

compared

with

the

preoperative

oidectomy

and

F0, there were significant differences compared with the

findings

and

compared

between

the

two

groups. increase recover showed

values were measured

in

total

thyroidectomy

patients

( p = 0.04). However,

at in of

all

groups,

the D Maximum

pitch

showed

a

gradual

obtained 1 month groups B

In

after

surgery,

these

changes were

significantly

larger extent

1

month

after

surgery

and

then

tended

to

until

irrespective of significantly a

and D

(no-IONM

groups)

irrespective

of

the

the use of

IONM. The D Maximum pitch

( p = 0.04

and p = 0.03,

respectively)

and

then decreased

smaller

decrease

in

the

IONM

group

compared irrespective

surgery

3 months

after

surgery

( Fig.

2 ).

the

no-IONM

group

at

1 week

after

operation

at

with

surgical

extent

( p = 0.02)

( Fig.

3 ).

of

Voice

range

profile

(VRP)

3.3.

Subjective

assessment

of

voice

quality

3.4.

the

results

for

the VRP, vocal

intensity

range was not

Among

different

according

to

the

surgical

extent

and and

GRBAS

scale

and

VHI

score

were

not

significantly

significantly

The

(data

not

shown).

Furthermore,

the

maximum

the

two

groups of

IONM

and no-IONM. The

IONM

different between

the voice

frequency

range did not show any

scores

tended

to

increase

during

the

early

period

after

minimum pitches of

VHI

difference However,

thyroidectomy but were not

in

groups

A

and

B

(hemithyroidectomy

groups).

statistically

significant between

the

in

groups C

and D

(total

thyroidectomy

groups),

the

groups

(Supplementary

Table

1,

0.05).

two

p >

Table 3 Proportion

of

normal

fundamental

frequency

on

the

pre-

and

postoperative

states.

F0

PO

1 week

F0

PO

1 month

F0

PO

3 months

F0

Preoperative

Hemithyroidectomy Group A

32 38

(85%)

26 26

(70.3%) (61.9%)

24 27

(64.9%) (64.3%)

26 27

(70.3%) (64.3%)

(90.5%)

Group B p -Value

0.727

0.434

0.957

0.572

thyroidectomy

Total

28 66

(96.6%) (89.2%)

25 46

(86.2%) (62.2%)

24 46

(82.8%) (62.2%)

25 49

(86.2%) (66.2%)

Group C Group D p -Value

0.439

0.018

0.044

0.042

fundamental

frequency;

PO = postoperative; Group A

and

C =

IONM

group; Group B

and D = non-IONM

group.

F0 =

114