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  • Q&A with Australian Health Practitioners

    Why has the full range of my voice since thyroid surgery not recovered?

    Related Topics
    Children's Health Speech Disorders
    I had a total thyroidectomy about 2 months ago but I still have a husky voice and unable to get full range of my voice. I was told my voice box was working. Why is my voice like this and how can I get my voice back? this is very depressing
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  • 41

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    A/Prof Daniel Novakovic

    Ear Nose and Throat (ENT) Surgeon

    Dr Daniel Novakovic is an Australian Otolaryngologist (ENT Surgeon) with postgraduate international dual subspecialty fellowship training in the fields of Laryngology and Head and Neck … View Profile

    Voice change after thyroid surgery is common. Cutting through the strap muscles of the neck can restrict the movement of the voice box (larynx) but this should be temporary.

    Ongoing hoarseness indicates that your vocal cord function is not normal i.e. either they are not coming together properly or the lining of the vocal cords is not vibrating properly. After thyroid surgery this is most commonly due to partial nerve weakness known as paresis in which the nerves suplying the vocal cords get bruised during surgery. The vocal cords may still move but they may not close as robustly as normal. This can be most accurately assessed using an examination called stroboscopy. If you continue to be troubled by your voice you should request to see an ENT doctor who performs laryngeal stroboscopy (there are not many of us around).

    Loss of pitch range (especially the upper part of the vocal register) indicates that the vocal cords are not tensioning properly. Once again injury to the nerves supplying the muscles of the voice box can cause this symptom.

    Your voice may come bvack to normal over time. If it is causing you significant distress I would recommend that you see an ENT surgeon who can do a stroboscopic examination of the vocal cords to find out what the problem is. It is likely that the first treatment recommeded will be some form of speech therapy depending upon the nature of the problem

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  • 27

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    Sharon Moore

    Speech Pathologist

    I am a Speech Pathologist with 30 years clinical experience, working over the years with a wide range of clients with communication and swallowing disorders. … View Profile

    It is most helpful for patients to be aware (before surgery) of the possible effects on voice following thyroid surgery,as per Dr Novakovic's explanation. Low key coaching and discussion on the use of ‘easy voice’ strategies to use following surgery can be very helpful in avoiding development of  compensatory muscle tension. A Speech Pathologist specialising in voice therapy is a good person to help. 
    If muscle tension  develops after surgery there are vocal techniques that can be used to correct muscle tension patterns, and it is advisable to correct these quickly so that they do not develp into patterns or habits which become difficult to change once established.
    If a paresis develops as Dr Novakovic described, there are some vocal exercises that encourage the ‘healthy’ vocal cord to move closer to the weaker cord, improving the possibility for vocal cord vibration while the weak cord is recovering function. This can improve voice quality and decrease the development of muscle tension difficulties in the laryngeal system as a whole, while it is adjusting and recovering from the surgery. 

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  • 32

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    Dr Matthew Broadhurst

    Ear Nose and Throat (ENT) Surgeon

    Dr Matt Broadhurst is a fellowship trained laryngeal surgeon specialising in laryngeal surgery and voice restoration. He returned to Brisbane from Boston, Massachusetts in 2007 … View Profile

    This is not an uncommon situation and I always have great sympathy for a patient in this situation.  Unfortuantely the “voice box” is actually not working, despite being told it is.  The larynx and vocal cords have the most dense nerve wiring of any region or organ in the body and even very subtle damage to one of the 4 main nerves to the vocal cords can cause hoarseness.  Fortunately most of the time the voice recovers but when it does not, or the vocal deficit is significant while waiting for nerve recovery(which might take 6 months) a range of simple interventions can be performed.  Such “injection laryngoplasty” techniques are now done in the office under local anaesthetic with no need to hospital admission or general anaesthetic which offers a great advantage to the patient.  A very careful videostroboscopy and laryngeal analysis is requried in this setting but results can be excellent.  Ensure your ENT is strongly trained in laryngeal surgery and voice disorders to get the best outcome.

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  • 18

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    anne j

    HealthShare Member

    Hi Dr Broadhurst
    you response interested me as I was told that the reason after my thyroidectomy voice lost was because I have tight muscles in my throat and I was referred to a voice pathologist which has helped a lot.  I was told the reason I feel mucus in my throat and when I talk is because my muscles are very tightand I am talking in my throat? not in the nasal area., luckly after 5 months or so of therapy I have my voice back finally after the operation 6 months ago and notice more improvement especially the last month. but I still get the mucus feeling and sometimes my voice goes because of the mucus feeling but have been told it is muscle tightness.  and to continue with my exercises.  what are your thoughts I understand you may not be able to answer as you have not seen my “voice box” etc., but am interested in your thought.  Thank you

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  • 15

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    Dr Philip Lovitt

    Chiropractor, Homeopath, Naturopath

    Chiropractor, naturopath, homeopath specializing in restorative health from Sports injuries to immune System dysyfunction, from young to senior with 37 years experience. View Profile

    A change or in particular a lack of thyroid hormone can cause swelling in the vocal cords. Also damage to the complex nerves to he larynx interfers with movement to the vocal cords and can affect speech. The recovery time is important here and some quick assistance such as vocal technics to relax muscles and injection laryngoplasty, may be needed to help function return.

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