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How Long After Thyroid Surgery Can You Sing

Voice Problems Following Thyroid Surgery Occur Without Damage To The Laryngeal Nerves

Can I Lose My Voice in Thyroid Surgery?

Contact: Kenneth Satterfield561-447-5521 703-519-1563


A study finds that procedures to preserve nerve integrity may not prevent voice problems after removal of the thyroid.

Boca Raton, FL — Nerve damage resulting from thyroid surgery is a feared consequence of the procedure. Damage to the recurrent laryngeal nerve, which powers the vocal cords, may occur without symptoms, leading some thyroid surgeons to examine the vocal folds preoperatively, and to perform fiberoptic laryngoscopy as part of postoperative follow-up. Injury to the superior laryngeal nerve is another voice-altering complication of thyroid surgery. The associated symptoms of superior laryngeal nerve injury can be nonspecific, and the subtle laryngoscopic manifestations are often overlooked. Advanced diagnostic techniques for evaluating superior laryngeal nerve function have been developed, recording a five to 28 percent incidence of this complication following thryoidectomy. The absence of effective treatment for superior laryngeal nerve palsy and the fact that recovery following nerve injury is poor makes prevention crucial.

Functional voice assessment: Voice testing was conducted pre-operative and one week and three months after thyroidectomy. A multidimensional approach to voice analysis was conducted at each visit.

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Getting Ready For Your Surgery

You and your care team will work together to get ready for your surgery.

Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you arent sure.

  • I take a blood thinner, such as:
  • Aspirin
  • I smoke or use an electronic smoking device .
  • I use recreational drugs.
  • About drinking alcohol

    The amount of alcohol you drink can affect you during and after your surgery. Its important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.

    • If you stop drinking alcohol suddenly, it can cause seizures, delirium, and death. If we know youre at risk for these complications, we can prescribe medications to help keep them from happening.
    • If you drink alcohol regularly, you may be at risk for other complications during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.

    Here are things you can do before your surgery to keep from having problems:

    About smoking

    If you smoke, you can have breathing problems when you have surgery. Stopping even for a few days before surgery can help. Your healthcare provider will refer you to our Tobacco Treatment Program if you smoke. You can also reach the program by calling .

    About sleep apnea

    Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing device for sleep apnea, bring it with you the day of your surgery.

    Using MyMSK

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    What Is A Thyroidectomy

    A thyroidectomy is an operation to remove all or part for the thyroid gland. It is the treatment for a number of different thyroid disorders including thyroid cancer, goitre, thyroid nodules and Graves Disease.

    Watch Surgeon Professor Neil Tolley at Imperial College in London talking about thyroid and parathyroid surgery

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    How Are Diseases Of The Larynx Treated

    Laryngoscopy thyroid surgery

    Your treatment options for conditions that affect the larynx can depend on your diagnosis. If your condition has been caused by vocal abuse, misuse or overuse, the treatment might be as simple as resting your voice for a small period of time. Your provider might also suggest voice or singing therapy to help you fully recover. This therapy is typically done by a speech-language pathologist.

    In some cases, you might need more than rest to treat your condition. If youve been diagnosed with laryngeal cancer, for example, treatment options could include:

    • Surgery.
    • Chemotherapy.

    Your treatment plan might involve a combination of these therapies.

    Treatment for conditions of the larynx and vocal cords can be very individual. The best option for you might not work for the next person. A few factors that will be considered when your provider is determining the best treatment plan for you can include:

    • Your medical condition.
    • Your age.
    • Your profession.

    Your healthcare provider will take all of these factors into account when creating your personal treatment plan. Talk to your provider about your goals and concerns about your treatment. Having an open conversation with your provider will help in the process of treating your condition.

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    Thyroid Surgery: An Introduction For The Vocal Artist Singer And Musician

    Voice changes areimportant considerations in thyroid surgery. Thyroidectomy, the removal of partor the whole thyroid gland, is a commonly performed operation that is done formyriad reasons, including thyroid cancers, nodules, goiter , and hyperthyroidism . Sometimes the diseaseprocess itself can affect the voice, but thyroid surgery too can cause voicedisturbances that musicians, especially singers, should be aware of.

    ThyroidFunction and Anatomy

    The thyroid is abutterfly-shaped gland that sits in the lower front of the neck. It has a rightlobe and a left lobe that are connected by the isthmus, or a bridge of thyroidtissue. It secretes hormones that control our overall metabolism, growth, anddevelopment. The amount of thyroid hormone produced by the gland is controlledby another hormone called the thyroid stimulating hormone , which isproduced by the pituitary gland.

    Located close to thethyroid gland are two nerves on each side of the neck that control the humanvoice. The major one is called the recurrent laryngeal nerve , whichtravels right behind the thyroid gland. It controls all but one of the musclesthat open and close the vocal cords, and are important for the voice, and forbreathing and swallowing. The second nerve is the superior laryngeal nerve. The internal SLN branch provides sensory information from the top partof the voice box and the external branch controls the cricothyroid muscle. Thismuscle helps project the voice and create higher pitch registers.

    Removing Your Thyroid Gland

    Thyroid surgery is done through an incision in the lower part of the front of your neck. It takes about 2 to 3 hours.

    During your surgery, your surgeon will examine your whole thyroid gland and remove the parts that have cancer. Theyll also check the lymph nodes next to your thyroid gland and remove any that have or might have cancer cells.

    • If half of your thyroid is removed, its called a lobectomy or hemi-thyroidectomy.
    • If your whole thyroid is removed, its called a total thyroidectomy.

    Your surgeon will talk with you before your surgery so you know what to expect.

    Nerve injuries

    There are 2 nerves very close to your thyroid gland that help your larynx work. These nerves are called the recurrent laryngeal nerve and the superior laryngeal nerve. They may be affected during your thyroid surgery.

    • Your recurrent laryngeal nerve goes behind your thyroid to your voice box. If your tumor is close to this nerve or this nerve is injured during your surgery, your vocal cords could be damaged. This can make your voice hoarse. Voice hoarseness is common after thyroid surgery and usually goes away with time.
    • Your superior laryngeal nerve helps you raise the volume and pitch of your voice. If this nerve gets weak or injured, the pitch and tone of your voice can be affected. This may make it hard for you to raise your voice or sing.


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    Hypocalcemia And Bone Health

    Your bones have been starved of calcium during the time you have had hyperparathyroidism, and will now have the chance to grow strong again. After successful parathyroid surgery, I recommend plenty of dietary calcium. If you do not take at least three daily servings of calcium-rich foods, you may prefer to take Caltrate Plus twice a day to promote healthy bones. In addition to these supplements, an exercise routine using weights is also recommended. Your vitamin D should be kept > 75 to enable your intestine to absorb the calcium in your diet.

    In a small number of patients who have parathyroid surgery, the remaining parathyroid glands have become lazy, and do not function properly immediately after surgery. It is very rare after the mini-surgery, but about 5% if you need both sides of the neck explored. This is usually temporary and causes the blood calcium level to drop below normal . Symptoms of hypocalcaemia include numbness and tingling in your hands, soles of your feet and around your lips. Some patients experience a “crawling” sensation in the skin, muscle cramps or headaches. These symptoms appear between 24 and 48 hours after surgery. It is rare for them to appear after 72 hours.

    Voice Affectations After Thyroidectomy

    Two years After Thyroid surgery | Thyroidectomy Update

    Guest over a year ago

    Guest over a year ago

    Guest over a year ago

    In reply to anonymous on 2009-04-10 – click to read

    Amy Joann185763 over a year ago

    Dottie over a year ago

    over a year ago

    I had my thyroidectomy just a week ago and I suffer the same extreme hoarsness of voice. I believe somehow my nerve was touched or perhaps my voice cord sweelt due to the insertion of respirator into my throat.

    I am afraid my voice will become hoarse the rest of life. I am a university professsor who depends on voice to earn living. I wonder if anyone can share your experience how do you cope with this problem? and any story related to my concern.

    I knew the risk of side effects of thyroidectomy therefore I searched a well=expereinced surgeon and waited for a month for my operation and what I was afraid still happened. I just hope it would be temporay. Any experince anyone can share with me ?


    over a year ago

    In reply to anonymous on 2005-09-09 – click to read

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    Does Thyroid Surgery Leave A Scar

    Like all surgeries that require an external incision, there is an initial scar from the incision made to remove some or all of your thyroid. Over time this scar will heal over 8 to 12 weeks and become barely noticeable if taken care of properly. For many patients, the scar will get so light over time that it is unrecognizable, especially if the scar treatment regimen and creams are followed.

    When going out in the sun, however, you need to make sure that you place sunscreen and a cover over the scar for the first 6 months to avoid redness in the area. Any ultraviolet light that comes in contact with these incision scars will darken and can be noticeable. Most patients will either wear a scarf or a bandaid when going outside to cover the incision for the first 6 months.

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    Days Before Your Surgery

    Follow your healthcare providers instructions for taking aspirin

    If you take aspirin or a medication that contains aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Aspirin can cause bleeding.

    Follow your healthcare providers instructions. Dont stop taking aspirin unless they tell you to. For more information, read the resource Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs , or Vitamin E.

    Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements

    Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements 7 days before your surgery. These things can cause bleeding. For more information, read the resource Herbal Remedies and Cancer Treatment.

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    Hypocalcaemia After Total Thyroidectomy Tingling And Numbness Of Fingers And Toes

    In up to 50% of patients who have a total thyroidectomy, the parathyroid glands do not function properly immediately. This is usually temporary and causes the blood calcium level to drop below normal . Symptoms of hypocalcaemia include numbness and tingling in your hands, soles of your feet and around your lips, and can become quite unpleasant. Some patients experience a “crawling” sensation in the skin, muscle cramps or headaches. These symptoms appear between 24 and 48 hours after surgery. It is rare for them to appear after 72 hours. Low blood calcium does not occur if only half the thyroid is removed.

    Hypocalcaemia is treated with calcium tablets. If you are having a total thyroidectomy, I will check your parathyroid hormone before you leave hospital. If it is low, I will send you home with calcium and calcitriol , which will usually be temporary. If you develop tingling in the fingertips, toes, or lips, your calcium maybe low. Take two extra caltrate tablets The symptoms of tingling/numbness should improve within 30-45 minutes of taking the tablets. If the symptoms persist, you should take two more tablets and wait another 45 minutes. If they still persist after 3 extra doses, call my office in working hours, or after hours report to your nearest emergency room to have your blood calcium checked.

    How Are Diseases Of The Larynx Diagnosed

    Thyroid Surgery at MIMS.

    Diseases of the larynx are usually diagnosed by a specialist a laryngologist or otolaryngologist. Your provider will start with a physical exam of your throat and larynx. This might involve a scope or a mirror thats used to look inside your throat.

    Depending on your symptoms, your provider might also want to do additional tests. These tests might include:

    • Imaging studies.
    • Biopsies.
    • Endoscopic examinations.

    If your provider thinks you might have vocal cord paralysis, a scope exam will be used to start the diagnosis. In some situations, your provider may also order a laryngeal electromyography . This test measures the nerve input to the laryngeal muscles. It can help diagnose and predict if youll recover vocal fold function.

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    How Is Thyroid Surgery Performed

    Thyroid surgery takes place in a hospital. Its important not to eat or drink anything after midnight before your surgery.

    When you arrive at the hospital, youll check in and then go to a preparation area where youll remove your clothes and put on a hospital gown. A nurse will insert an IV in your wrist or your arm to administer fluids and medication.

    Before surgery, youll meet with your surgeon. Theyll do a quick examination and answer any questions you may have about the procedure. Youll also meet with the anesthesiologist who will be administering the medicine that makes you sleep throughout the procedure.

    When its time for surgery, youll enter the operating room on a gurney. The anesthesiologist will inject medicine into your IV. The medicine may feel cold or sting as it enters your body, but it will quickly put you into a deep sleep.

    The surgeon will make an incision over the thyroid gland and carefully remove all or part of the gland. Because the thyroid is small and surrounded by nerves and glands, the procedure may take 2 hours or more.

    Youll wake up in the recovery room, where the staff will make sure youre comfortable. Theyll check your vital signs and administer pain medication as needed. When youre in stable condition, theyll transfer you to a room where youll remain under observation for 24 to 48 hours.

    The Next Few Days Were The Worst

    Apparently, I am not one of those people who handle anesthesia very well. I had migraines and nausea for several long days after the fact.

    My incision? No pain whatsoever. The surgeon said its one of those miraculous things where they cut the nerves there during surgery and by the time you heal, theres no pain. I couldnt turn my neck very well for almost two weeks. I drove one week later but to turn my head required turning my entire body. Dont play on driving for at least a week, if not a little longer. Energy isnt abundant.

    My incision was closed with stitches that would dissolve behind some kind of surgical tape that was supposed to fall off in 10 days or so. It never did so I used nail polish remover and a Q-tip to break the bonds and get it off no big deal. I never saw the stitches and that was fine.

    In regard to eating, because I felt ill, I only wanted bland food for several days after surgery. But, theres no way that Id recommend you chew a steak or anything like that in the days afterward. Youll need to get used to your limitations, which include feeling a little odd when swallowing.

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    What To Expect After Thyroid Surgery

    After thyroid surgery, you will probably stay in hospital for one or two nights to recover from surgery. Your neck wound will be closed with stitches, adhesive strips or small clips.

    Your nursing team will talk to you about how to care for your surgical wound site once you go home to prevent it becoming infected. The surgeon may arrange blood tests to check on your recovery.

    Most people who have thyroid surgery will feel better within 12 weeks, but recovery may take longer for some people.

    For more on this, see What to expect after thyroid cancer.

    Learn more about:

    What Type Of Voice Changes Might I Expect After Thyroid Surgery


    If the vocal cord is paralysed, there is a coarse change to the character of the voice which can be described as hoarseness. Some patients experience such changes before surgery and this is a worrisome sign because it suggests that the recurrent laryngeal nerve is compressed/invaded by an aggressive thyroid cancer or that the nerve is severely stretched by a very large goitre.

    Injury to the superior laryngeal nerve leads to a loss of projection , loss of high pitch of the singing voice and inability to sing in falsetto .

    More subtle changes in voice can be demonstrated using professional recording equipment but such changes remain undetected by patients and clinicians and are of doubtful social, professional or personal implications.

    In the absence of any nerve injury, patients with intact vocal fold motility might still experience voice fatigue during phonation , difficulties with high pitch voice and a more monotone pitch that can be more than two semitones lower.

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