POST-THYROIDECTOMY/POST-PARATHYROIDECTOMY
VOICE CHANGES WITHOUT VOCAL CORD MOTILITY ALTERATIONS
Recurrent (inferior)
laryngeal nerve injury is widely discussed in the literature as a common cause
of dysphonia following thyroid surgery. Injury to the external branch of the
superior laryngeal nerve can also cause more subtle alterations of voice, often
difficult to assess (such as difficulty to produce high-frequency vocal
sounds). However, voice changes may be observed even without alterations of
vocal cord motility. Potential causes of voice changes in these cases include:
Cricothyroid
muscle movement disorder
Mucosal
damage, hematoma, inflammation or vocal fold laryngeal edema induced by faulty
venous or lymphatic drainage or both
Surgical
trauma with prelaryngeal strap muscle fixation to the laryngotracheal axis, a
maneuver that may alter the voice by reducing vertical movements
Emotional
and behavioral conditions (such as mental stress) may also be involved
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