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  • Post-Thyroid Surgery ---> Vocal Nerve Issues

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    Old 08-13-2009, 11:36 AM   #1
    micro
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    Post-Thyroid Surgery ---> Vocal Nerve Issues

    Hello!

    I am posting on behalf of my mom. Thanks in advance for any insights and suggestions! Some background info-

    My mom had a complete thyroidectomy in Oct 08. Every post op was normal except for her voice. It was hoarse and low. After following up with the surgeon for 9 months, he says that everything is normal and that her issue could be due to reflect. (He never mentioned the possibility of vocal chord damage. We are certainly upset about his lack of acknowledgment of that possibility).

    Anyway, we went to an ENT who specializes in voice issues. Upon performing the ENG...which is a test to assess the functional status of the vocal nerves...they found that of those two that control pitch, one was damage to the point beyond repair. While the other one was slightly damage and manages some function.

    Her issue is controlling pitch. The vocal chords themselves are fine.

    Does anyone have any experience with this? We were told that the only was to fix this is to surgically manipulate the vocal chords to compensate for the lack of nerve function. The other way is to have voice therapy. The benefits of these are questionable. But I'd like anyone's opinion of this situation. The doctor said her voice won't get worse. If it doesn't improve in the next 3 months, then her voice will be permanently like this.

    Any advice or suggestions would be greatly appreciated. Thanks for reading this!

     
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    Old 12-15-2009, 10:42 AM   #2
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    Re: Post-Thyroid Surgery ---> Vocal Nerve Issues

    I had a total thyroidectomy in May 08. By December of the same year, since I had met my deductible with the surgery and RAI, I had a thyroplasty done by injection. This improved my voice and breathing for a few months - was supposed to last up to a year. So this year, I had thyroplasty done in November and it was a prosthetic inserted to close the gap in the vocal fold. My voice sounds more like my voice but cuts out all the time and the breathing is actually worse. I was so in hopes that my vocal chord would WAKE UP - they said it was possible - but after a year and a half, my ENT thought it probably wouldn't come back. This is so, so frustrating because I was a singer and now cannot breathe good enough to sing....let me know how your situation improves....that's positive thinking, huh?? Chris in Colorado

     
    Old 12-15-2009, 10:35 PM   #3
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    Re: Post-Thyroid Surgery ---> Vocal Nerve Issues

    Hey Chris,

    My mom is currently exploring thyroplasty as well.

    The ENT told us that the anatomy of her airway does not make her a candidate for injections. And like you said, it's only a temporary fix.

    We've done ENG studies to check her nerve functions. Both sides of her recurrent laryngeal nerves show reduced function. It is also unlikely it'll return due to the time that has elapsed since surgery.

    Anyway, thyroplasty is the next option to explore. Even though thyroplasty will reduce the size of her open airway, it's something that we aren't too concern about. Her lifestyle and occupation does not require any sort of oxygen intense activity. We'll be looking into this.. Good luck to you!

     
    Old 12-17-2009, 11:39 AM   #4
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    Re: Post-Thyroid Surgery ---> Vocal Nerve Issues

    Dear Micro -
    Please be so cautious about the thyroplasty!! I really thought I would be able to breathe better afterwards but I think my airway is blocked more now than before!! My ENT was so excited about changing the pitch of my voice, I think he misunderstood that I was ALREADY having breathing issues BEFORE! He said at my post op visit that he "had to sacrifice some airway to get the pitch right" in my voice. That should have been better explained before I made the decision to have they thyroplasty. Please just ask alot of questions about airway - this is really a pain! I can't read a book out loud to my 2 year old grandson without sounding like I have emphysema!!! Don't think I can EVER sing again!
    Happy Holidays and good luck - Chris

     
    Old 12-17-2009, 12:08 PM   #5
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    Re: Post-Thyroid Surgery ---> Vocal Nerve Issues

    Thanks for the informative reply. I'll certainly explore this option in great details. Thank you for pointing that out to me. I definitely wish you the very best! Good luck and have a wonderful holiday!

     
    Old 01-04-2010, 06:28 AM   #6
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    Re: Post-Thyroid Surgery ---> Vocal Nerve Issues

    Hi - it was great reading your reply because I just had total thyroidectomy surgery on Dec. .17th and immediately thereafter I've been having voice issues as well as breathing issues. I'd guess that i am getting only50% of my air intake and my voice has little pitch, small range of voice and no sregnth behind it. My Dr told me to waituntil after the holidays (giving it 2 weeks) and then to call him. He said that I will need a scope performed to "see" what's happening in my vocal cord box. The problem is that I 'talk' for a living conducting webinars and am extremely active and now can not get enough air to support that. So, I considered potential options for repaore and inserting fat or teflon onto my chords could be an option. To your point, I think that it would block my airway more to gain the pitch. In a quandry here.. Any suggestions?

    Thanks so much...

    Amy

    Quote:
    Originally Posted by cbruington View Post
    Dear Micro -
    Please be so cautious about the thyroplasty!! I really thought I would be able to breathe better afterwards but I think my airway is blocked more now than before!! My ENT was so excited about changing the pitch of my voice, I think he misunderstood that I was ALREADY having breathing issues BEFORE! He said at my post op visit that he "had to sacrifice some airway to get the pitch right" in my voice. That should have been better explained before I made the decision to have they thyroplasty. Please just ask alot of questions about airway - this is really a pain! I can't read a book out loud to my 2 year old grandson without sounding like I have emphysema!!! Don't think I can EVER sing again!
    Happy Holidays and good luck - Chris

     
    Old 01-07-2010, 05:11 PM   #7
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    Re: Post-Thyroid Surgery ---> Vocal Nerve Issues

    Quote:
    Originally Posted by activemother View Post
    Hi - it was great reading your reply because I just had total thyroidectomy surgery on Dec. .17th and immediately thereafter I've been having voice issues as well as breathing issues. I'd guess that i am getting only50% of my air intake and my voice has little pitch, small range of voice and no sregnth behind it. My Dr told me to waituntil after the holidays (giving it 2 weeks) and then to call him. He said that I will need a scope performed to "see" what's happening in my vocal cord box. The problem is that I 'talk' for a living conducting webinars and am extremely active and now can not get enough air to support that. So, I considered potential options for repaore and inserting fat or teflon onto my chords could be an option. To your point, I think that it would block my airway more to gain the pitch. In a quandry here.. Any suggestions?

    Thanks so much...

    Amy

     
    Old 01-07-2010, 05:14 PM   #8
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    Re: Post-Thyroid Surgery ---> Vocal Nerve Issues

    Amy - if you just had your thyroidectomy on December 17th, don't be in a hurry to do ANYTHING but heal!! It can take up to a year for your vocal chord to wake up!! I waited 6 months before I got an injection of Radiesse which worked for a few months...then waited a whole year before I had the thyroplasty which was a piece of plastic inserted over the larynx. Please talk to your ENT or surgeon because I'm sure they'll tell you that it's too soon to do anything. Chris in Colorado

     
    Old 01-08-2010, 05:28 AM   #9
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    Re: Post-Thyroid Surgery ---> Vocal Nerve Issues

    Thanks so much for your reply. I did have a scope done on monday and it confirmed that i have a paralized left vocal cord. The good news is that it showed some signs of twitching which can be good news but the Dr. told us that 1/3 recover, 1/3 make some improvement and 1/3 stay the same. He strongly suggested voice therapy ASAP (which I will try) and that we give it time. It's difficult to be patient. My personality is different in a room with noise as I can't converse with others. My son (age 11) is worried about me and my job is picking back up again in a week. As you know, this is super frustrating.

    How is your breathing these days? Can they go back in to make your plastic insert smaller? Can you walk up the stairs without feeling out of breath? Can you tell me about the temporary insert as well as a bit about the plastic insert procedures?

    Thanks sooo much..

     
    Old 01-19-2010, 02:16 PM   #10
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    Re: Post-Thyroid Surgery ---> Vocal Nerve Issues

    hi please take a look at my old posts. I never had a thyroplasty and was in your shoes.
    My friends and clients think my voice now is the same (no cant sing anymore, no more voice overs) but speaking and breathing is excellent compared to before. Just search posts for vocal cord problems. Amazing speech therapist helped me fom Yale and we did it long distance.

    Julyg

     
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