Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine

Voice Changes Common After Thyroid Cancer Surgery

MedicalResearch.com Interview with:

Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine

Dr. Haymart

Megan Rist Haymart MD
Associate Professor
Metabolism, Endocrinology and Diabetes Clinic
Michigan Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Thyroid cancer is a common malignancy with surgery considered one of the primary treatments. Complications from thyroid surgery can lead to long-term voice problems. However, few studies have used validated scales to quantify the impact of thyroid surgery on patient voice. Prior work has largely focused on single institution studies with high volume surgeons or claims data with reports of specific nerve injury.

We surveyed a diverse cohort of patients affiliated with SEER sites Georgia and Los Angeles to identify the prevalence, severity and correlates of poor voice outcomes following surgery for differentiated thyroid cancer.

We found that out of 2,325 patients 25.8% reported voice changes lasting greater than 3 months after surgery, 12.7% had abnormal voice per a validated voice scale (Voice Handicap Index- 10), and 4.7% reported a diagnosis of vocal fold motion impairment. We also identified patient factors associated with abnormal voice 2-4 years post op.

MedicalResearch.com: What should readers take away from your report?

Response: Patients and physicians should be aware of the high prevalence of abnormal voice after surgery for thyroid cancer. They should discuss this pre-operatively and consider risks when planning extent of surgery. In addition, if patients have voice problems that persist post operatively, they should alert their doctors and discuss options for postoperative evaluation and potential rehabilitation. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Patients and physicians should be aware of the high prevalence of abnormal voice after surgery for thyroid cancer. They should discuss this pre-operatively and consider risks when planning extent of surgery. In addition, if patients have voice problems that persist post operatively, they should alert their doctors and discuss options for postoperative evaluation and potential rehabilitation, 

MedicalResearch.com: Is there anything else you would like to add?

Response: It is important to balance the risks and benefits of cancer treatments, including treatments of thyroid cancer. To find the right balance, it is necessary to understand the prevalence of complications and side effects from thyroid cancer treatments. More research is needed to determine which patients need more versus less intensive thyroid cancer treatment.

This study is supported through my R01 from the NCI.

Citation:

Kovatch KJ, Reyes-Gastelum D, Hughes DT, Hamilton AS, Ward KC, Haymart MR. Assessment of Voice Outcomes Following Surgery for Thyroid Cancer. JAMA Otolaryngol Head Neck Surg. Published online July 18, 2019. doi:10.1001/jamaoto.2019.1737

 

Jul 18, 2019 @ 9:52 pm 

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