Impact of Uncomplicated Total Thyroidectomy on Voice and Swallowing Symptoms: a Prospective Clinical Trial

  • Jiannis K. HajiioannouEmail author
  • Eleni Sioka
  • Stergiani Tsiouvaka
  • Christos Korais
  • Dimitrios Zacharoulis
  • John Bizakis
Original Article


Voice and swallowing alterations are frequently reported after thyroidectomy, even in absence of nerve injury. The symptoms impair the quality of life. Aim of the study was to evaluate prospectively vocal function and swallowing symptom changes after total thyroidectomy in the early and late postoperative period. Prospective observational study. All consecutive patients scheduled for total thyroidectomy were included. Subjective voice evaluation using the Greek version of Voice Handicap Index (VHI) was performed preoperatively and at 2nd postoperative day, 1 month, 12 months postoperatively to assess the functional outcome. Laryngoscopy was performed at the same timing. Subjective swallowing evaluation using the Swallowing Impairment score (SIS) evaluated the swallowing symptoms. The study population included 125 patients. Total VHI score differed significantly between preoperative values and at 48 h and 1 year postoperatively (p = 0.000). Significant changes were observed for the functional and emotional domain of VHI between preoperative and 48 h postoperatively (p = 0.001, 0.003, respectively). There were statistically significant changes for physical domain of VHI between preoperative values and values at 48 h and 1 year (p = 0.000, 0.001, respectively). Regarding the swallowing symptoms, the mean postoperative score at 1 month did not differ significantly from the mean preoperative score (p = 0.103). Swallowing alterations showed a tendency to increase 48 h postoperatively and decreased thereafter. Swallowing score at 1 year postoperatively was statistical significant lower compared to preoperative values. Even with intact laryngeal nerves, transient voice and swallowing alterations may occur after total thyroidectomy. Patients should be informed about these mild changes to lower anxiety following the operation.


Total thyroidectomy Voice handicap index Swallowing disorders Thyroid surgery Voice disorders 


Compliance with Ethical Standards

The study was conducted after approval of the Institutional Ethics Committee. All clinical investigations were conducted in accordance with the guidelines in the Declaration of Helsinki.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Association of Surgeons of India 2019

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, University Hospital of LarissaUniversity of ThessalyLarissaGreece
  2. 2.Department of Surgery, University Hospital of LarissaUniversity of ThessalyLarissaGreece

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