ObjectiveTo compare the effect of robotic thyroidectomy and endoscopic thyroidectomy on the voice function. MethodsThe clinical data of 181 patients with differentiated thyroid cancer admitted to Panzhihua Central Hospital of Sichuan Province from March 2022 to June 2023 were analyzed retrospectively. According to the operative mode, this patients were divided into two groups: the endoscope group (n=91) and the robot group (n=90). The subjective and objective acoustic indicators were compared between the two groups at 1 day before operation and 1 week, 1 month and 3 months after operation. ResultsThere were no significant difference in voice handicap index (VHI)-10 scores between the two groups at different time points before and after operation (P>0.05). There were no significant difference of VHI-10 scores between preoperative and different postoperative phases in the robot group (P>0.05). The score of VHI-10 at different postoperative phases in the endoscopic group was higher than that at 1 d before operation (P<0.05). The incidence of voice dysfunction (VHI-10 score ≥8) was 1.1% (1/90), 1.1% (1/90) and 0.0% (0/90) in the robot group, 1.1% (1/91) , 2.2% (2/91) and 0.0% (0/91) in the endoscope group at 1 week, 1 month and 3 months after operation respectively, there were no significant difference between the two groups (P>0.05). The fundamental frequency of patients in the endoscopic group was lower than that at 1 d before operation (P<0.05), and there was no significant difference between each phase after operation and at 1 d before operation of fundamental frequency in the robot group (P>0.05). The fundamental frequency of patients in the endoscopic group was lower than that in the robot group at 1 week after operation (P<0.05). The maximum phonation time of each phase after operation in the robot group was not significantly different from that at 1 d before operation (P>0.05). The maximum phonation time of 1 week after operation in the endoscopic group was shorter than that at 1 d before operation (P<0.05) and also shorter than that in the robot group (P<0.05). There were no significant difference in fundamental frequency perturbation, amplitude perturbation, harmonic noise ratio and voice disorder severity index between the two groups at different phases before and after operation (P>0.05). ConclusionCompared with endoscopic thyroidectomy, the voice function of robotic thyroidectomy via bilateral axillary breast approach is better.
ObjectiveTo investigate the voice function before and after surgery in patients undergoing axillary thyroidectomy with da Vinci robotic Xi system. MethodsSeventy female patients who underwent robotic thyroid cancer radical resection in Panzhihua Central Hospital from March 2022 to March 2023 were selected. The voice dysfunction index scale VHI-10, auditory perception evaluation scale GRBAS and voice analysis software were used to evaluate the voice function of patients subjectively and objectively at 1 day before operation, 1 week and 3 months after surgery. ResultsThe operative time was (128.13±48.36) min, the amount of blood loss was (16.36±8.23) mL. There were no significant differences in the points of function, physiology and emotion evaluated by VHI-10 scale at 1 week and 3 months after operation compared with those before operation (P>0.05). There were no significant differences in the three characteristics points of voice roughness, breathiness, and strain evaluated by GRBAS scale at 1 week and 3 months after operation (P>0.05). At 1 week after operation, the total hoarseness grade and asthenia evaluated by GRBAS scale were increased in different degrees as compared with those before operation and the difference was statistically significant (P<0.05), while the total hoarseness grade and asthenia points were decreased at 3 months after operation and there was no significant difference as compared with that before operation (P>0.05). Voice acoustic analysis results showed that there were no significant differences in fundamental frequency, jitter, shimmer and harmonic to noise ratio of the patients between at 1 week or 3 months after operation and before operation (P>0.05). The maximum phonation time (MPT) of patients was decreased at 1 week after operation as compared with that before operation, and the difference was statistically significant (P<0.05). The MPT of the patients recovered at 3 months after operation, and there was no significant difference as compared with that before operation (P>0.05). The dysphonia severity index (DSI) of patients at 1 week after surgery was decreased as compared with that before surgery, and the difference was statistically significant (P<0.05). The DSI was increased at 3 months after operation and there was no significant difference as compared with that before operation (P>0.05). ConclusionRobot radical thyroidectomy via axillary breast is safe and can protect the voice function.