ABSTRACT Changes in voice caused by thyroid hormone suspension before high-dose radioactive iodine therapy (HD-RIT) in patients with total thyroidectomy Seo, Eun Ji Department of Clinical Speech/Language Pathology The Graduate School Chonbuk National University Purpose This study aimed to objectivel...
ABSTRACT Changes in voice caused by thyroid hormone suspension before high-dose radioactive iodine therapy (HD-RIT) in patients with total thyroidectomy Seo, Eun Ji Department of Clinical Speech/Language Pathology The Graduate School Chonbuk National University Purpose This study aimed to objectively compare and analyze the changes in voice that is caused by thyroid hormone suspension before going into high-dose radioactive iodine therapy(HD-RIT) in the patients with total thyroidectomy. By comparing and analyzing the changes in voice objectively by using acoustic parameter and subjectively by the patients themselves, treatment interventions can be found for the patients with total thyroidectomy, and can be used as essential data. Subjects and Method For this study, a total of 50 patients (6 males, 44females) with the age of 47±10.84 in average were participated as subjects. These patients received total thyroidectomy at ENT and internal medicine at Chonbuk National University Hospital between February and July 2012 due to differentiated thyroid cancer and then were referred to nuclear medicine for HD-RIT, but do not have vocal fold dysfunction caused by injured or paralyzed recurrent laryngeal nerve (RLN) and superior laryngeal nerve (SLN). Voice samples were collected at the time of post-operation (Post-OP), before high-dose radioactive iodine therapy (Pre-RIT), and after high-dose radioactive iodine therapy (Post-RIT). Acoustic analysis was performed by using Multi-Dimensional Voice Program Advanced, 5105 (MDVP) after measuring the sustained vowels /a/, /e/, /i/, /o/, /u/ and the maximum phonation time (MPT). K-VHI (Korea-Voice handicap index) was used for subjective evaluation. Results and Conclusion According to the comparison analysis of the three periods, which were Post-OP, Pre-RIT, and Post-RIT, mfo(Hz) was significantly reduced in all of the vowels /a/, /e/, /i/, /o/, /u/ as the hormone was discontinued, and especially the front vowels /e/ and the middle vowel /a/ showed a significant decrease in frequency-related parameters (mFo, Fhi, Flo) compared to other vowels. This can be related to the reduction in vocal range. As thyroid hormone was discontinued, Shim(%) and APQ(%) values, which are the parameters related to the degree of aggressiveness, showed a significant increase in the middle vowel /a/ and the back vowel /u/. This can be assumed that it is related to the increased changes in the vocal intensity. As thyroid hormone was discontinued, noise-related parameter SPI showed a significant increased in the back vowel /o/. This can be assumed that it is related to the increase in noise. As thyroid hormone was discontinued, emotional index was significantly decreased in VHI. This can be assumed that the responsive factors of one's own voice disorders were significantly decreased in the patients with vocal handicap.
ABSTRACT Changes in voice caused by thyroid hormone suspension before high-dose radioactive iodine therapy (HD-RIT) in patients with total thyroidectomy Seo, Eun Ji Department of Clinical Speech/Language Pathology The Graduate School Chonbuk National University Purpose This study aimed to objectively compare and analyze the changes in voice that is caused by thyroid hormone suspension before going into high-dose radioactive iodine therapy(HD-RIT) in the patients with total thyroidectomy. By comparing and analyzing the changes in voice objectively by using acoustic parameter and subjectively by the patients themselves, treatment interventions can be found for the patients with total thyroidectomy, and can be used as essential data. Subjects and Method For this study, a total of 50 patients (6 males, 44females) with the age of 47±10.84 in average were participated as subjects. These patients received total thyroidectomy at ENT and internal medicine at Chonbuk National University Hospital between February and July 2012 due to differentiated thyroid cancer and then were referred to nuclear medicine for HD-RIT, but do not have vocal fold dysfunction caused by injured or paralyzed recurrent laryngeal nerve (RLN) and superior laryngeal nerve (SLN). Voice samples were collected at the time of post-operation (Post-OP), before high-dose radioactive iodine therapy (Pre-RIT), and after high-dose radioactive iodine therapy (Post-RIT). Acoustic analysis was performed by using Multi-Dimensional Voice Program Advanced, 5105 (MDVP) after measuring the sustained vowels /a/, /e/, /i/, /o/, /u/ and the maximum phonation time (MPT). K-VHI (Korea-Voice handicap index) was used for subjective evaluation. Results and Conclusion According to the comparison analysis of the three periods, which were Post-OP, Pre-RIT, and Post-RIT, mfo(Hz) was significantly reduced in all of the vowels /a/, /e/, /i/, /o/, /u/ as the hormone was discontinued, and especially the front vowels /e/ and the middle vowel /a/ showed a significant decrease in frequency-related parameters (mFo, Fhi, Flo) compared to other vowels. This can be related to the reduction in vocal range. As thyroid hormone was discontinued, Shim(%) and APQ(%) values, which are the parameters related to the degree of aggressiveness, showed a significant increase in the middle vowel /a/ and the back vowel /u/. This can be assumed that it is related to the increased changes in the vocal intensity. As thyroid hormone was discontinued, noise-related parameter SPI showed a significant increased in the back vowel /o/. This can be assumed that it is related to the increase in noise. As thyroid hormone was discontinued, emotional index was significantly decreased in VHI. This can be assumed that the responsive factors of one's own voice disorders were significantly decreased in the patients with vocal handicap.
주제어
#total thyroidectomy, thyroid hormone suspension, high-dose radioactive iodine therapy, voice
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