Post-thyroidectomy voice dysfunction may occur in the absence of laryngeal nerve injury. Strap muscle division has been hypothesized as one potential contributor to dysphonia.
Vocal-function data, prospectively recorded before and after thyroidectomy from two high-volume referral institutions, were utilized. Patient-reported symptoms, laryngoscopic, acoustic, and aerodynamic parameters were recorded at 2 weeks and 3 months postoperatively. Patients with and without sternothyroid muscle division during surgery were compared for voice changes. Patients with laryngeal nerve injury, sternohyoid muscle division, arytenoid subluxation or no early postoperative follow-up evaluation were excluded. Differences between study groups and outcomes were compared using t-tests and rank-sum tests as appropriate.
Of 84 patients included, 45 had sternothyroid division. Distribution of age, gender, extent of thyroidectomy, specimen size, and laryngeal nerve identification rates did not differ significantly between groups. There was a significant predilection for or against sternothyroid muscle division according to medical center. No significant difference in reported voice symptoms was observed between groups 2 weeks or 3 months after thyroidectomy. Likewise, acoustic and aerodynamic parameters did not differ significantly between groups at these postoperative study time points.
Sternothyroid muscle division is occasionally employed during thyroidectomy to gain superior pedicle exposure. Division of this muscle does not appear to be associated with adverse functional voice outcome, and should be utilized at surgeon discretion during thyroidectomy.
"On the other hand, Jaffe and Young  showed that strap muscle division does not result in any subjective or objective functional sequelae. The functional impact of cutting ST muscle during thyroidectomy on postoperative voice was reported by Henry et al.  in 2008. They showed no significant difference in both voice symptoms and aerodynamic parameters. "
[Show abstract][Hide abstract] ABSTRACT: Background:
Cutting the sternothyroid (ST) muscle is a useful technique to expose the superior pole of thyroid gland during thyroidectomy. In this study, we evaluated the impact of partial cutting of the ST muscle on postoperative vocal outcomes after total thyroidectomy.
A retrospective review of 57 patients who underwent total thyroidectomy with central neck dissection for micropapillary thyroid carcinoma was conducted. Group A (n = 26) included those without cutting the ST muscle, while group B (n = 31) included patients whose muscle was partially cut at the superior pole. All patients underwent voice analysis before the operation and 2 weeks and 1 month after the surgery, and the outcomes were compared between the two groups.
There were no differences between the two groups regarding the outcomes at each time of voice analysis. Group A showed a decrease of maximum frequency 2 weeks after surgery but showed no difference after 1 month. Group B showed a mild decrease in maximum frequency 2 weeks after surgery, but the difference was not significant.
Partial cutting of ST muscle during thyroidectomy is useful to expose the superior pole without significant negative impact on postoperative outcomes of vocal analysis.
The Scientific World Journal 09/2013; 2013:416535. DOI:10.1155/2013/416535 · 1.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The Illinois Bell fiber network in the Chicago MSA (market service
area) was designed with survivability in mind. The built-in
survivability protects against the most vulnerable component of the
network, the outside plant. To improve network survivability, changes
are being made to the network. The resulting modified architecture
double hubs offices and prevents future occurrences of total isolation.
The modified network builds on the strengths of the embedded fiber
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modified network is capable of effectively utilizing changes and
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Global Telecommunications Conference, 1989, and Exhibition. Communications Technology for the 1990s and Beyond. GLOBECOM '89., IEEE; 12/1989
[Show abstract][Hide abstract] ABSTRACT: Voice and swallowing complaints are common after thyroidectomy, but their etiology is not completely understood. Manipulation of the endolaryngeal soft tissues, pharyngeal constrictor muscles, and recurrent laryngeal nerves may all result in symptoms. In addition, the external branch of the superior laryngeal nerve and cricothyroid muscle may play a role in postoperative dysphonia. We review the literature related to the scope of voice complaints after thyroidectomy. We also discuss several studies describing the surgical anatomy of the external branch of the superior laryngeal nerve as it relates to thyroidectomy. Our surgical technique, which includes routine visualization of the external branch of the superior laryngeal nerve, is then described.
Operative Techniques in Otolaryngology-Head and Neck Surgery 03/2009; DOI:10.1016/j.otot.2009.02.009
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