Voice function comparison of 70 patients undergoing robotic radical thyroidectomy <i>via</i> axillary and breast approach before and after surgery: a single-center series of case study_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Peigen ¹ , LUO Jie ¹ , LUO Bin ¹ , ZHANG Zeyu ¹ , MA Yinhua ¹ , CHEN Daibo ² , YANG Yinghong ¹ ,  YAN Jing ¹

1. Department of General Surgery, Panzhihua Central Hospital, Panzhihua, Sichuan 617000, P. R. China;
2. Department of Otolaryngology, Panzhihua Central Hospital, Panzhihua, Sichuan 617000, P. R. China;

Corresponding?author：

YAN Jing, Email: 1455819058@qq.com

Keywords：

thyroid cancer; robotic thyroid surgery; voice function; series of case study

DOI：

10.7507/1007-9424.202305048

Video：

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Objective To investigate the voice function before and after surgery in patients undergoing axillary thyroidectomy with da Vinci robotic Xi system. Methods Seventy female patients who underwent robotic thyroid cancer radical resection in Panzhihua Central Hospital from March 2022 to March 2023 were selected. The voice dysfunction index scale VHI-10, auditory perception evaluation scale GRBAS and voice analysis software were used to evaluate the voice function of patients subjectively and objectively at 1 day before operation, 1 week and 3 months after surgery. Results The operative time was (128.13±48.36) min, the amount of blood loss was (16.36±8.23) mL. There were no significant differences in the points of function, physiology and emotion evaluated by VHI-10 scale at 1 week and 3 months after operation compared with those before operation (P>0.05). There were no significant differences in the three characteristics points of voice roughness, breathiness, and strain evaluated by GRBAS scale at 1 week and 3 months after operation (P>0.05). At 1 week after operation, the total hoarseness grade and asthenia evaluated by GRBAS scale were increased in different degrees as compared with those before operation and the difference was statistically significant (P<0.05), while the total hoarseness grade and asthenia points were decreased at 3 months after operation and there was no significant difference as compared with that before operation (P>0.05). Voice acoustic analysis results showed that there were no significant differences in fundamental frequency, jitter, shimmer and harmonic to noise ratio of the patients between at 1 week or 3 months after operation and before operation (P>0.05). The maximum phonation time (MPT) of patients was decreased at 1 week after operation as compared with that before operation, and the difference was statistically significant (P<0.05). The MPT of the patients recovered at 3 months after operation, and there was no significant difference as compared with that before operation (P>0.05). The dysphonia severity index (DSI) of patients at 1 week after surgery was decreased as compared with that before surgery, and the difference was statistically significant (P<0.05). The DSI was increased at 3 months after operation and there was no significant difference as compared with that before operation (P>0.05). Conclusion Robot radical thyroidectomy via axillary breast is safe and can protect the voice function.

Citation： LIU Peigen, LUO Jie, LUO Bin, ZHANG Zeyu, MA Yinhua, CHEN Daibo, YANG Yinghong, YAN Jing. Voice function comparison of 70 patients undergoing robotic radical thyroidectomy via axillary and breast approach before and after surgery: a single-center series of case study. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(10): 1244-1248. doi: 10.7507/1007-9424.202305048 Copy

1.	Solis-Pazmino P, Salazar-Vega J, Lincango-Naranjo E, et al. Thyroid cancer overdiagnosis and overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador. BMC Cancer, 2021, 21(1): 42.
2.	Furuya-Kanamori L, Bell KJL, Clark J, et al. Prevalence of differentiated thyroid cancer in autopsy studies over six decades: a meta-analysis. J Clin Oncol, 2016, 34(30): 3672-3679.
3.	Mao Y, Xing M. Recent incidences and differential trends of thyroid cancer in the USA. Endocr Relat Cancer, 2016, 23(4): 313-322.
4.	Kim MJ, Chung WY. Yonsei experience of 5 000 gasless transaxillary robotic thyroidectomies: reply. World J Surg, 2018, 42(7): 2281-2282.
5.	Chen F, Tian G, Kong D, et al. Radiofrequency ablation for treatment of benign thyroid nodules: A PRISMA-compliant systematic review and meta-analysis of outcomes. Medicine (Baltimore), 2016, 95(34): e4659.
6.	盧曼, 孫金中, 孫圣榮. 腔鏡甲狀腺手術發展與選擇. 中國普外基礎與臨床雜志, 2022, 29(6): 816-822.
7.	Pavlidis ET, Psarras KK, Symeonidis NG, et al. Robot-assisted thyroidectomy versus open thyroidectomy in the treatment of well differentiated thyroid carcinoma. JSLS, 2021, 25(3): e2021.00032.
8.	曾令娟, 馬靜, 范林軍, 等. 達芬奇機器人甲狀腺癌根治術后引流管拔除時機的臨床對照研究. 中國普外基礎與臨床雜志, 2020, 27(4): 460-463.
9.	Lee J, Lee JH, Nah KY, et al. Comparison of endoscopic and robotic thyroidectomy. Ann Surg Oncol, 2011, 18(5): 1439-1446.
10.	Lee S, Ryu HR, Park JH, et al. Excellence in robotic thyroid surgery: a comparative study of robot-assisted versus conventional endoscopic thyroidectomy in papillary thyroid microcarcinoma patients. Ann Surg, 2011, 253(6): 1060-1066.
11.	Lee J, Nah KY, Kim RM, et al. Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc, 2010, 24(12): 3186-3194.
12.	Henry LR, Helou LB, Solomon NP, et al. Functional voice outcomes after thyroidectomy: an assessment of the Dsyphonia Severity Index (DSI) after thyroidectomy. Surgery, 2010, 147(6): 861-870.
13.	Kuhn MA, Bloom G, Myssiorek D. Patient perspectives on dysphonia after thyroidectomy for thyroid cancer. J Voice, 2013, 27(1): 111-114.
14.	中國醫師協會外科醫師分會甲狀腺外科醫師委員會, 中國研究型醫院學會甲狀腺疾病專業委員會. 機器人手術系統輔助甲狀腺和甲狀旁腺手術專家共識. 中國實用外科雜志, 2016, 36(11): 1165-1170.
15.	徐文, 李紅艷, 胡蓉, 等. 嗓音障礙指數量表中文版信度和效度評價. 中華耳鼻咽喉頭頸外科雜志, 2008, 6(9): 670-675.
16.	Hirano M. Psycho-acoustic evaluation of voice: GRBAS scale for evaluating the hoarse voice // Hirano M, ed. Clinical examination of voice. Wien. New York: Springer, Verlag, 1981: 81-84.
17.	Song CM, Park JS, Park HJ, et al. Voice outcomes of transoral robotic thyroidectomy: Comparison with conventional trans-cervical thyroidectomy. Oral Oncol, 2020, 107: 104748.
18.	Jacobson BH, Johnson A, Grywalski C, et al. The voice handicap index (VHI): development and validation. Am J Speech Lang Pathol, 1997, 6(3): 66-70.
19.	王征, 張浩, 李偉漢, 等. 術中持續與間斷神經監測技術在腔鏡輔助甲狀腺手術中的對比研究. 中華普外科手術學雜志(電子版), 2020, 14(2): 170-173.
20.	李海鵬, 劉新洪, 魏福國, 等. 術中喉返神經監測技術在完全腔鏡甲狀腺手術中的應用研究. 腹腔鏡外科雜志, 2015, 20(4): 266-268.
21.	孫德云, 張雪松, 高瑞崗, 等. 甲狀腺手術患者的語音評估及嗓音分析. 臨床耳鼻咽喉頭頸外科雜志, 2017, 31(13): 998-1002.
22.	Potenza AS, Araujo Filho VJF, Cernea CR. Injury of the external branch of the superior laryngeal nerve in thyroid surgery. Gland Surg, 2017, 6(5): 552-562.
23.	Papadakis CE, Asimakopoulou P, Proimos E, et al. Subjective and objective voice assessments after recurrent laryngeal nerve-preserved total thyroidectomy. J Voice, 2017, 31(4): 515. e15-515. e21.
24.	劉思維, 邵駿. 嗓音聲學分析方法的研究現狀. 臨床耳鼻咽喉頭頸外科雜志, 2022, 36(12): 966-970, 976.
25.	張武寧, 李永湘, 吳鋮林, 等. 聲帶息肉患者的嗓音聲學分析及意義. 廣西醫科大學學報, 2013, 30(3): 450-452.

1. Solis-Pazmino P, Salazar-Vega J, Lincango-Naranjo E, et al. Thyroid cancer overdiagnosis and overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador. BMC Cancer, 2021, 21(1): 42.
2. Furuya-Kanamori L, Bell KJL, Clark J, et al. Prevalence of differentiated thyroid cancer in autopsy studies over six decades: a meta-analysis. J Clin Oncol, 2016, 34(30): 3672-3679.
3. Mao Y, Xing M. Recent incidences and differential trends of thyroid cancer in the USA. Endocr Relat Cancer, 2016, 23(4): 313-322.
4. Kim MJ, Chung WY. Yonsei experience of 5 000 gasless transaxillary robotic thyroidectomies: reply. World J Surg, 2018, 42(7): 2281-2282.
5. Chen F, Tian G, Kong D, et al. Radiofrequency ablation for treatment of benign thyroid nodules: A PRISMA-compliant systematic review and meta-analysis of outcomes. Medicine (Baltimore), 2016, 95(34): e4659.
6. 盧曼, 孫金中, 孫圣榮. 腔鏡甲狀腺手術發展與選擇. 中國普外基礎與臨床雜志, 2022, 29(6): 816-822.
7. Pavlidis ET, Psarras KK, Symeonidis NG, et al. Robot-assisted thyroidectomy versus open thyroidectomy in the treatment of well differentiated thyroid carcinoma. JSLS, 2021, 25(3): e2021.00032.
8. 曾令娟, 馬靜, 范林軍, 等. 達芬奇機器人甲狀腺癌根治術后引流管拔除時機的臨床對照研究. 中國普外基礎與臨床雜志, 2020, 27(4): 460-463.
9. Lee J, Lee JH, Nah KY, et al. Comparison of endoscopic and robotic thyroidectomy. Ann Surg Oncol, 2011, 18(5): 1439-1446.
10. Lee S, Ryu HR, Park JH, et al. Excellence in robotic thyroid surgery: a comparative study of robot-assisted versus conventional endoscopic thyroidectomy in papillary thyroid microcarcinoma patients. Ann Surg, 2011, 253(6): 1060-1066.
11. Lee J, Nah KY, Kim RM, et al. Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc, 2010, 24(12): 3186-3194.
12. Henry LR, Helou LB, Solomon NP, et al. Functional voice outcomes after thyroidectomy: an assessment of the Dsyphonia Severity Index (DSI) after thyroidectomy. Surgery, 2010, 147(6): 861-870.
13. Kuhn MA, Bloom G, Myssiorek D. Patient perspectives on dysphonia after thyroidectomy for thyroid cancer. J Voice, 2013, 27(1): 111-114.
14. 中國醫師協會外科醫師分會甲狀腺外科醫師委員會, 中國研究型醫院學會甲狀腺疾病專業委員會. 機器人手術系統輔助甲狀腺和甲狀旁腺手術專家共識. 中國實用外科雜志, 2016, 36(11): 1165-1170.
15. 徐文, 李紅艷, 胡蓉, 等. 嗓音障礙指數量表中文版信度和效度評價. 中華耳鼻咽喉頭頸外科雜志, 2008, 6(9): 670-675.
16. Hirano M. Psycho-acoustic evaluation of voice: GRBAS scale for evaluating the hoarse voice // Hirano M, ed. Clinical examination of voice. Wien. New York: Springer, Verlag, 1981: 81-84.
17. Song CM, Park JS, Park HJ, et al. Voice outcomes of transoral robotic thyroidectomy: Comparison with conventional trans-cervical thyroidectomy. Oral Oncol, 2020, 107: 104748.
18. Jacobson BH, Johnson A, Grywalski C, et al. The voice handicap index (VHI): development and validation. Am J Speech Lang Pathol, 1997, 6(3): 66-70.
19. 王征, 張浩, 李偉漢, 等. 術中持續與間斷神經監測技術在腔鏡輔助甲狀腺手術中的對比研究. 中華普外科手術學雜志(電子版), 2020, 14(2): 170-173.
20. 李海鵬, 劉新洪, 魏福國, 等. 術中喉返神經監測技術在完全腔鏡甲狀腺手術中的應用研究. 腹腔鏡外科雜志, 2015, 20(4): 266-268.
21. 孫德云, 張雪松, 高瑞崗, 等. 甲狀腺手術患者的語音評估及嗓音分析. 臨床耳鼻咽喉頭頸外科雜志, 2017, 31(13): 998-1002.
22. Potenza AS, Araujo Filho VJF, Cernea CR. Injury of the external branch of the superior laryngeal nerve in thyroid surgery. Gland Surg, 2017, 6(5): 552-562.
23. Papadakis CE, Asimakopoulou P, Proimos E, et al. Subjective and objective voice assessments after recurrent laryngeal nerve-preserved total thyroidectomy. J Voice, 2017, 31(4): 515. e15-515. e21.
24. 劉思維, 邵駿. 嗓音聲學分析方法的研究現狀. 臨床耳鼻咽喉頭頸外科雜志, 2022, 36(12): 966-970, 976.
25. 張武寧, 李永湘, 吳鋮林, 等. 聲帶息肉患者的嗓音聲學分析及意義. 廣西醫科大學學報, 2013, 30(3): 450-452.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Voice function comparison of 70 patients undergoing robotic radical thyroidectomy via axillary and breast approach before and after surgery: a single-center series of case study

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