Patient Self-Assessment and Acoustic Voice Analysis in Screening of Postoperative Vocal Fold Paresis and Paralysis
| Autor: | Elina Penttilä, K Mäkinen, J M Kärkkäinen, Heikki Löppönen, Maria Heikkinen, M Qvarnström |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Self-Assessment
medicine.medical_specialty recurrent laryngeal nerve Vocal Cords Acoustic voice analysis vocal fold paresis vocal cord paresis 03 medical and health sciences 0302 clinical medicine Original Research Articles otorhinolaryngologic diseases medicine Paralysis Recurrent laryngeal nerve Humans Patient self assessment Prospective Studies 030223 otorhinolaryngology Paresis business.industry Thyroid Acoustics Thyroid surgery Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis parathyroid surgery Parathyroid surgery medicine.symptom Vocal cord paresis business |
| Zdroj: | Scandinavian Journal of Surgery |
| ISSN: | 1799-7267 1457-4969 |
| DOI: | 10.1177/14574969211007036 |
| Popis: | Background and objective: The aim of this study was to evaluate the utility of two items in vocal fold paresis and paralysis screening after thyroid and parathyroid surgery: patient self-assessment of voice using the Voice Handicap Index and computer-based acoustic voice analysis using the Multi-Dimensional Voice Program. Methods: This was a prospective study of 181 patients who underwent thyroid or parathyroid surgery over a 1-year study period (2017). Preoperatively, all patients underwent laryngoscopic vocal fold inspection and acoustic voice analysis, and they completed the Voice Handicap Index questionnaire. Postoperatively, all patients underwent laryngoscopy prior to hospital discharge; 2 weeks after the surgery, they completed the Voice Handicap Index questionnaire a second time. Two weeks postoperatively, patients with vocal fold paresis or paralysis and 20 randomly selected controls without vocal fold paresis or paralysis underwent a follow-up acoustic voice analysis. Results: Fourteen patients had a new postoperative vocal fold paresis or paralysis. Postoperatively, the total Voice Handicap Index score was significantly higher (p = 0.040) and the change between preoperative and postoperative scores was greater (p = 0.028) in vocal fold paresis or paralysis patients. A total postoperative Voice Handicap Index score > 30 had 55% sensitivity, and 90% specificity, for vocal fold paresis or paralysis. In the postoperative Multi-Dimensional Voice Program analysis, vocal fold paresis or paralysis patients had significantly more jitter (p = 0.044). Postoperative jitter > 1.33 corresponded to 55% sensitivity, and 95% specificity, for vocal fold paresis or paralysis. Conclusions: In identifying postoperative vocal fold paresis or paralysis, patient self-assessment and jitter in acoustic voice analysis have high specificity but poor sensitivity. Without routine laryngoscopy, approximately half of the patients with postoperative vocal fold paresis or paralysis could be overlooked. However, if the patient has no complaints of voice disturbance 2 weeks after thyroid or parathyroid surgery, the likelihood of vocal fold paresis or paralysis is low. |
| Databáze: | OpenAIRE |
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