갑상선 절제술 후 발생하는 주관적인 음성 기능 저하의 위험 요인에 대한 연구

Risk Factors of Deteriorated Voice Quality in Patients Who Underwent Thyroidectomy

Background and Objectives: Quality of voice may be deteriorated after thyroidectomy without any injury to recurrent laryngeal nerve. While there have been several studies showing the change of acoustic parameters after thyroidectomy, factors related to deteriorated voice quality have been rarely studies. In this study, we sought to analyze the factors associated to deteriorated voice quality after thyroidectomy. Materials and Methods: We made a retrospective review of 35 patients who underwent thyroidectomy for papil-lary thyroid carcinoma. Voice analysis including acoustic analysis, voice handicap index 10 (VHI-10), and GRBAS score was conducted before and 3 months after surgery. Patients were grouped according to the amount of increase in VHI-10 after surgery ; group A (ΔVHI<7) and group B (ΔVHI≥7). Clinicopathologic factors associated to patients of group B were analyzed and changes of parameters from acoustic analysis in each group were evaluated. Results : Patients of group B were associated with age ≥ 45 years (p=0.025) and showed borderline association to total thyroidectomy (p=0.075) and tumor size ≥ 1cm (p=0.086). Multivariate analysis demonstrated that those with age ≥ 45 years were independently associated to deteriorated quality of voice (p=0.014, HR=18.38). Patients of group B were also associated to significant deterioration of high pitch (p<0.001) and Grade score with borderline significance (p=0.054). Conclusion: Patients older than 45 years may have higher risk of deterioration of quality of voice after thyroi-dectomy based on increase of VHI-10 score (ΔVHI≥7). Association with deterioration of high pitch should also be considered in these patients.