{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:36:18Z","timestamp":1787315778837,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize non\u2010neural post\u2010thyroidectomy dysphonia (PTD) by analyzing long\u2010term voice outcomes in patients with no evidence of nerve injury on postoperative laryngoscopy and electromyography (EMG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary referral center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We reviewed 527 post\u2010thyroidectomy patients with intact vocal fold mobility and normal EMG results at 2 to 3 months postoperatively. Voice evaluations, including acoustic analysis, voice range profile, aerodynamic study, and VHI\u201010, were performed preoperatively and 3 days, 2 weeks, 1, 3, 6, and 12 months postoperatively. Linear mixed models and machine learning were used to assess the effects of sex, age, surgical extent, and preoperative fundamental frequency (F0\n                      <jats:sub>pre<\/jats:sub>\n                      ) on voice parameters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fundamental frequency (F0) and speaking fundamental frequency (SFF) declined immediately after surgery, with more prolonged reduction in older patients (\u226545 years) and those with high F0\n                      <jats:sub>pre<\/jats:sub>\n                      . VHI\u201010 increased during the early postoperative\u00a0period, particularly after total thyroidectomy, but returned to near\u2010baseline by 6 to 12 months. Older age was associated with delayed VHI\u201010 recovery. Maximum frequency (F\n                      <jats:sub>max<\/jats:sub>\n                      ) decreased in the early period after total thyroidectomy. F0\n                      <jats:sub>pre<\/jats:sub>\n                      and age were main predictors of F0 and SFF at 1 and 3 months, while surgical extent predicted VHI\u201010 and F\n                      <jats:sub>max<\/jats:sub>\n                      at 1 month.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Voice changes may occur even when the recurrent laryngeal nerve and the external branch of the superior laryngeal nerve are preserved during thyroidectomy. Although most alterations improve over time, some voice parameters may not fully recover, with outcomes influenced by sex, age, surgical extent, and F0\n                      <jats:sub>pre<\/jats:sub>\n                      . These findings may aid in counseling patients with non\u2010neural PTD.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70168","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T12:04:21Z","timestamp":1773230661000},"page":"963-972","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Non\u2010Neural Post\u2010Thyroidectomy Dysphonia: Long\u2010Term Voice Outcomes in 527 Patients"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7070-8560","authenticated-orcid":false,"given":"Jeong\u2010Yeon","family":"Ji","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Seoul National University Bundang Hospital, Seoul National University College of Medicine Seongnam\u2010si South 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