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首页> 外文期刊>JAMA otolaryngology-- head & neck surgery >Assessment of Voice Outcomes Following Surgery for Thyroid Cancer
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Assessment of Voice Outcomes Following Surgery for Thyroid Cancer

机译：对甲状腺癌手术后的语音结果评估

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Importance: An increasing number of surgeries are being performed for differentiated thyroid cancer (DTC). Long-Term voice abnormalities are a known risk of thyroid surgery; however, few studies have used validated scales to quantify voice outcomes after surgery. Objective: To identify the prevalence, severity, and factors associated with poor voice outcomes following surgery for DTC. Design, Setting, and Participants: A cross-sectional, population-based survey was distributed via a modified Dillman method to 4185 eligible patients and linked to Surveillance, Epidemiology and End Results (SEER) data from SEER sites in Georgia and Los Angeles, California, from February 1, 2017, to October 31, 2018. Multivariable logistic regression and zero-inflated negative binomial analysis were performed to determine factors associated with abnormal voice. Participants included patients undergoing surgery for DTC between January 1, 2014, and December 31, 2015, excluding those with voice abnormalities before surgery. Main Outcomes and Measures: Abnormal Voice Handicap Index (VHI-10) score, defined as greater than 11. The VHI-10 is designed to quantify 10 psychosocial consequences of voice disorders on a Likert scale (0, never; to 4, always). Results: A total of 2632 patients (63%) responded to the survey and 2325 met the inclusion criteria. With data reported as unweighted number and weighted percentage, 1792 were women (77.4%); weighted mean (SD) age was 49.4 (14.4) years. Of these, 599 patients (25.8%) reported voice changes lasting more than 3 months following surgery, 272 patients (12.7%) were identified as having an abnormal VHI-10 score, and 105 patients (4.7%) reported vocal fold motion impairment diagnosed by laryngoscopy. In multivariable analysis, factors associated with an abnormal VHI-10 score included age 45 to 54 years (reference, ≤44 years; odds ratio [OR], 1.49; 95% CI, 1.05-2.11), black race (OR, 1.73; 95% CI, 1.14-2.62), Asian race (OR, 1.66; 95% CI, 1.08-2.54), gastroesophageal reflux disease (OR, 1.67; 95% CI, 1.15-2.43), and lateral neck dissection (OR, 1.99; 95% CI, 1.11-3.56). Conclusions and Relevance: A high prevalence of abnormal voice per validation with the VHI-10 emphasizes the need for heightened awareness of voice abnormalities following surgery and warrants consideration in the preoperative risk-benefit discussion, planned extent of surgery, and postoperative rehabilitation.
机译：重要性：正在对分化的甲状腺癌（DTC）进行越来越多的手术。长期语音异常是甲状腺手术的已知风险;然而，很少有研究使用过验证的尺度来量化手术后的语音结果。目的：鉴定DTC手术后手术后声音结果不良的患病率，严重程度和因素。设计，设定和参与者：通过修改的Dillman方法将基于人口的调查分发到4185个符合条件的患者，并与加利福尼亚州格鲁吉亚和洛杉矶的Seer网站的监测，流行病学和最终结果（SEER）数据相关联，从2017年2月1日到2018年10月31日。进行多变量逻辑回归和零充气的负二进制分析，以确定与异常声音相关的因素。参与者包括2014年1月1日至2015年12月31日在2015年12月31日之间接受过DTC的患者，除了手术前的声音异常。主要结果和措施：声音差异指数（VHI-10）得分，定义为大于11. VHI-10旨在量化语音障碍的10个心理社会后果在李克特量表中（0，从不留到4个，总是） 。结果：共有2632名患者（63％）回应调查，2325岁符合纳入标准。报告称为未加权数量和加权百分比，1792名是女性（77.4％）;加权平均值（SD）年龄为49.4（14.4）岁。其中，599名患者（25.8％）报告的声音变化持续超过3个月后，术后322名患者（12.7％）被确定为vhi-10异常，105名患者（4.7％）报告诊断出声带运动障碍通过喉镜检查。在多变量分析中，与VHI-10异常分数相关的因素包括45至54岁（参考，≤44岁;赔率比[或]，1.49; 95％CI，1.05-2.11），黑种族（或1.73; 95％CI，1.14-2.62），亚洲比赛（或1.66; 95％CI，1.08-2.54），胃食管反流疾病（或1.67; 95％CI，1.15-2.43）和侧颈部分布（或1.99 ; 95％CI，1.11-3.56）。结论和相关性：VHI-10对每个验证的异常声音的高度普及强调了手术后声音异常的认识的需要，并在术前风险讨论，手术程度和术后康复的认证。

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