PROTECTION OF VOICE AFTER THYROID SURGERY
Voice loss or voice alterations after thyroid surgery is a complication that doctors who perform the surgery suffer as much as patients. It is of greater concern, especially for vocal artists, teachers, and people with vocal skills. The main voice/speech nerves (recurrent laryngeal nerve) are two-sided, with the thyroid organ spacing between trakea and the esophagus. In unilateral palse of these nerves (sometimes the tumor itself can destroy the nerve) may not cause speech alterations or voice changes may not become noticeable.
The likelihood of a one-sided palsy in a person who hasn’t undergone thyroid surgery before is about 6-7%, and this rate is lower in experienced surgeons. Most of laryngeal nerve paralyses recover within a few months, and return to normal unless the nerve is heavily damaged. If you’ve had thyroid surgery before, nerve injury rates significantly increase. In the case of unilateral nerve palsy, voicelessness and changes in voice are observed after surgery. Superior laryngeal nerves are again observed in areas close to thyroid glands. When this nerve is affected, voice changes named horseness, having trouble drinking water, being unable to speak out loud are seen commonly.
I believe that the laryngeal nerve monitoring, developed over the last three decades, has greatly improved sound security. During surgery, this device is based on a vocal cord that monitors muscle movements, giving very low currents to the nerves. A distinct sound empathy and a typical wave shape on the monitor test the strength of the nerve (Picture).
I use it personally for all my thyroid and parathyroid surgeries. It is highly recommended worldwide, especially in cases where second surgery is required, in large goitres and thyroid cancer surgeries.