Functional voice and swallowing outcomes after robotic thyroidectomy by a gasless unilateral axillo-breast approach: comparison with open thyroidectomy

• Published in: Surgical endoscopy Vol. 26; no. 7; pp. 1871 - 1877
• Main Authors: Tae, Kyung, Kim, Ki Yong, Yun, Bo Ram, Ji, Yong Bae, Park, Chul Won, Kim, Dong Sun, Kim, Tae Wha
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.07.2012; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Acoustics; Adult; Aged; Applied sciences; Biological and medical sciences; Computer science; control theory; systems; Control theory. Systems; Deglutition Disorders - etiology; Deglutition Disorders - physiopathology; Deglutition Disorders - prevention & control; Endoscopy; Exact sciences and technology; Gastroenterology; General aspects; Gynecology; Hepatology; Humans; Laryngoscopy; Lymphatic system; Medical sciences; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Neck; Postoperative Care; Preoperative Care; Proctology; Prospective Studies; Questionnaires; Robotics; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of endocrine glands; Surgical outcomes; Thyroid cancer; Thyroid Nodule - physiopathology; Thyroid Nodule - surgery; Thyroidectomy; Thyroidectomy - adverse effects; Voice Disorders - etiology; Voice Disorders - physiopathology; Voice Disorders - prevention & control; Voice Quality; Young Adult; Axillo-breast approach; Postthyroidectomy syndrome; Endoscopic thyroidectomy; Robotic thyroidectomy; Swallowing; Voice; Endoscopic surgery; Prognosis; Thyroidectomy; Robotics; Medicine; Treatment; Breast; Endoscopy; Mammary gland; Comparative study
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-011-2116-0

Background Voice and swallowing alterations are common complaints after thyroidectomy, even in the absence of laryngeal nerve impairment. However, voice and swallowing functions after robotic thyroidectomy have not been thoroughly investigated. This study compared the functional outcomes for voice and swallowing after robotic thyroidectomy and conventional open thyroidectomy. Methods The study prospectively analyzed the voice and swallowing functions of patients with thyroid nodules who underwent robotic thyroidectomy by a gasless unilateral axillo-breast (GUAB) approach (50 cases) or by conventional open thyroidectomy (61 cases) from September 2009 to October 2010. Videolaryngostroboscopy or flexible laryngoscopy was performed pre- and postoperatively. Subjective voice and swallowing alterations were assessed by questionnaire preoperatively and then 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively. In addition, objective acoustic voice analysis was performed using a Multidimensional Voice Program, with Voice Range Profiles and maximum phonation times measured preoperatively and then 1 week, 1 month, 3 months, and 6 months postoperatively. Results Subjective postoperative voice function was significantly better in the robotic group at 1 day, 1 month, and 3 months postoperatively than in the open group. The mean values of fundamental frequency, jitter, shimmer and noise-to-harmonic ratio before and after surgery did not differ between the two groups. However, the frequency range and the highest frequency were significantly better in the robotic group than in the open group at 3 months postoperatively. Subjective swallowing function did not differ between the two groups. Conclusion Postoperative voice function is better with robotic thyroidectomy using the GUAB approach than with conventional open thyroidectomy. This is an advantage of robotic thyroidectomy by the GUAB approach in addition to the excellent cosmesis.