Application Of Voice And Swallowing Function Assessment And Voice Training After Thyroidectomy

Objective:To explore the effects of speech function and possible influencing factors of postoperative patients,on the day before surgery,and the 7th and 30th day after surgery,we gave objective acoustic test and subjective voice and swallowing function evaluation to patients with no recurrent laryngeal nerve injury and vocal cord paralysis after thyroidectomy.Systematic voice training was given for 4 weeks to discuss the selection and application of voice training methods in these patients,and to clarify the clinical efficacy of voice training for these patients.Methods:1.The experimental group consists 38 patients with thyroid surgery,22 females and16 males,while the control group consists 40 patients with neck non-thyroid surgery,22females and 18 males.The objective voice parameters were measured by dynamic laryngoscope,DiVAS voice acoustic analysis system and Electroglottograph on the first day before operation,the seventh and the thirtieth day after operation.Using VHI-10 to collect subjective scores of voice;the scores of swallowing subjective scale were collected by standard swallowing function scale.Paired t-test was performed on the data of the experimental group and the control group at different time before and after operation.Independent sample t-test was performed between the experimental group and the control group.2.There were 19 patients with abnormal vocal sinus after operation,including 12females and 7 males.After systematic voice training,objective voice parameters and subjective scale scores were collected,and two independent sample t-tests were performed on the variable values before and after voice training.Results:1.On the day before operation,there was no significant difference in voice parameters between the male experimental group and the control group;FO and shimmer values of the experimental group were lower than those of the control group in female patients.2.On the 7^th day after operation,FO,DSI and CQ in female patients of experimental group were lower than those in the control group,and shimmer of male patients of experimental group was lower than those in the control group.3.On the 30^th day after operation,there was no significant difference in male voice parameters between the control group and the experimental group,while DSI values of the female patients in the experimental group were lower than those of the control group.4.In the experimental group,the MPT value of male patients on the 7th day after surgery was less than the day before surgery.In the female patients,the F0,Jitter,MPT and DSI on the 7th day after surgery were significantly different from the first day before surgery.The DSI and CQ on the 30th day after surgery were significantly different from the day before surgery.5.Male patients in the experimental group had significant VHI scores change on the7th day after surgery and on the 1st day before surgery.The difference in SSA total scores between the 7th day after surgery compared with the first day before surgery and the 30th day after surgery compared with the first day before surgery is significant.Female patients in the experimental group had significant differences in VHI and SSA on the 7th and 30th day after surgery and on the 1st day before surgery.In the female patients,the difference between the VHI and SSA total scores of the experimental group and the control group on the 7th day after surgery and the 30th day after surgery were significant.In male patients,the VHI and SSA scores of the experimental group and the control group were significantly different at 30 days after surgery.6.Shimmer,MPT and DSI of male patients were significantly different before and after voice training,while F0,MPT and DSI of female patients were significantly different.There were also significant differences in VHIV-10 scores between male and female patients.Conclusion:1.Patients with thyroidectomy may have some abnormalities in vocal parameters and swallowing abnormalities even if there is no obvious recurrent laryngeal nerve injury.In addition to gender factors,anterior laryngeal muscle scar and mass relief should also be considered.Standardized voice and swallowing assessment should be part of the standardized preoperative and postoperative assessment of patients undergoing thyroid surgery.2.Systematic voice training can effectively help these patients recover their voice after surgery,and help them return to life and society as soon as possible.