Navegando por Palavras-chave "laryngeal nerve bottom"

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    Qualidade vocal de pacientes submetidos à tireoidectomia com monitorização do nervo laríngeo inferior
    (Universidade Federal de São Paulo (UNIFESP), 2014-06-25) Takimoto, Roberto Massao [UNIFESP]; Cervantes, Onivaldo Cervantes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: An attempt was made to estimate the inferior laryngeal nerves monitoring impact on thyroidectomized patient?s vocal quality. Study Design: Prospective clinic randomized double-blind trial. Methods: Eighty-five patients were evaluated, men and women, median age 48,19 yrs., with no thyroid hormone dysfunctions. They were operated without (group A ? 40 patients) or with (group B ? 45 patients) inferior laryngeal nerves monitoring. The groups were controlled by gender, age, tobacco, thyroid volume, surgery extent, post-op hypoparathyroidism, type of disease (benign or malignant), TNM classification, ASA classification, laryngeal trauma and difficulty during the intubation. Patients were excluded because: severe alteration in grade (perceptive evaluation) before surgery, previous neck surgery, previous laryngoscopic alterations , previous neck radiotherapy , neck dissection and the ones that did not come to the post-op appointment. All the patients went through perceptive evaluation (Grade, Roughness, Breathiness, Asthenia, Strain and Instability), laryngoscopy, acoustic vocal analysis (F0, jitter, shimmer, GNE and hoarseness diagram) and voice-related quality of life (V-RQOL). These evaluations were performed before and after surgery (1st and 4th week). Results: Group A had 8.57% of paralysis versus 7.5% in group B in the first week post-op (p=1.000) and 4.29% versus 6.25% in the fourth week post-op (p=0.865). In the perceptive evaluation, only breathiness in the fourth week post-op, showed significant difference between the groups (25% of altered evaluations in group A versus 6.7% in group B, p=0,041). However, when the patients were compared with themselves, evaluating the status before versus after the surgery, none of the evaluated parameters, not even the breathiness showed any significant difference. Twenty seven (27.05%) percent of all patients (both groups) showed worse grade (perceptive evaluation) in the first week post-op and 28.23% in the fourth week postop. In the vocal acoustic analysis, none of the parameters showed significant difference between the groups. The median F0 (Hz) in women was 202.62 (before surgery), 198.19 (1st week post-op) and 191.90 (4th week post-op) in group A, and 193.48 (before surgery), 190.63 (1st week post-op) and 186.81 (4th week post-op) in group B. In the V-RQOL, there was not any significant difference, nether between the groups nor before versus after surgery. The median total scores were 91.25 (before surgery), 91.69 (1st week post-op) and 92.19 (4th week post-op) in group A, and 93.78 (before surgery), 96.22 (1st week post-op) and 98.39 (4th week post-op) in group B. Conclusion: At the present study, there was no impact, nether improvement nor worsening, in vocal quality of thyroidectomized patients under inferior laryngeal nerves monitoring.