THYROID and VOICE

What are the signs and symptoms?

sinais e sintomas na tiroide

• Thyroid diseases can manifest in different ways, namely:
• Enlarged thyroid (goiter), being visible or palpable in the central region of the neck
• Thyroid with visible or palpable nodules
• Hoarseness/dysphonia, difficulty swallowing/breathing
• Alteration of thyroid function, hyperfunctioning (hyperthyroidism) or underfunctioning (hypothyroidism), which can be associated with autoimmune diseases.
  

sinais e sintomas na voz

• Voice disorders can manifest as follows: 
• Easily fatigued when trying to speak for longer or with more intensity than usual, often ignored and not valued. 
• Hoarseness or dysphonia. 
• Alteration in voice quality or difficulty in identifying with one’s own voice, in terms of age or gender. 
• Difficulty swallowing or breathing.
  

CAUSES

The association between the two pathologies is very common and may share the same origin.

The thyroid, whether enlarged (goiter), presenting nodules, or having cancer, can interfere with speech, swallowing, and breathing functions, either through compressive or even invasive effects. Voice changes typically arise from vocal abuse and misuse, from injuries to the vocal cords (polyps, nodules, tumors), but they can also occur in the context of a physiological aging process (presbyphonia) or because we do not identify with our own voice. Very often, these problems occur after surgery on the thyroid, neck, or chest.

Diagnosis

Given the multiple causes, the existence of a multidisciplinary team for evaluation and treatment becomes essential, which includes otorhinolaryngology and head and neck surgery, endocrinology, and speech therapy. This integrated approach allows for a thorough assessment of the thyroid and voice, enabling the best treatment and rehabilitation.

TREATMENTS

Treatment options vary depending on the disease in question and can include speech therapy and more or less invasive treatments, under local or general anesthesia. Examples include thyroidectomy, suspended laryngoscopy for the injection of hyaluronic acid/botulinum toxin into the vocal cords, suspended laryngoscopy for the removal of vocal cord lesions, or even laryngeal reinnervation.

DO YOU HAVE A NODULE ON THE THYROID GLAND?

The thyroid nodules are extremely common in the general population, particularly in women over the age of 45.

Here is the translated paragraph in English:

"Only 5% to 10% are malignant, whereas the majority are benign. Good medical practices require examinations and biopsies for thyroid nodules based on what is observed in the ultrasound, so generally, nodules smaller than 1 cm are not indicated for biopsy. A thyroid nodule with benign characteristics should be monitored with ultrasounds, and if it increases by more than 20% in size or if suspicious characteristics emerge, a new fine-needle aspiration cytology or surgical procedure for definitive analysis should be performed.

If the result of the ultrasound-guided aspiration cytology/biopsy indicates an inconclusive result (follicular tumor or atypia of indeterminate significance), the risk of malignancy increases substantially, reaching values of 10 to 20%. In these cases, thyroid surgery known as lobectomy or hemithyroidectomy is indicated, which involves the excision of half of the thyroid for definitive diagnosis. If the analysis result from the thyroid gland reveals a malignant tumor, total thyroidectomy may be necessary.

Malignant thyroid tumors are typically treated with total removal of the thyroid gland or total thyroidectomy. Papillary thyroid carcinoma, which accounts for 80% of malignant thyroid tumors, has an excellent prognosis, especially the earlier and more assertive the treatment is. When the patient has metastases in the lymph nodes, removal of the lymph nodes in the neck should also be performed."

Thyroid surgery, known as thyroidectomy, is one of the most commonly performed surgeries in the neck region. The classic approach begins with an incision in the neck, which inevitably results in a scar on the skin.

For this reason, various endoscopic techniques have been developed to reduce or eliminate this scar in other areas of the body.

A new form of thyroidectomy, performed endoscopically through the mouth and without leaving scars on the skin. This new technique shows results and complications similar to the "classic" procedure, meaning it achieves the same results as a "conventional" thyroidectomy with the advantage of leaving no scar on the neck.

The limitations/disadvantages of this procedure are:

If the thyroid is very large, it cannot be removed through the endoscope opening;

If there are lymph nodes invaded by tumor in the neck (cervical metastases);

If the tumor is already in a very advanced stage;

The use of this technique requires an increase in surgical time.

Are you interested and would like to know more?

Schedule an appointment with our specialist doctors.