{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:19:09Z","timestamp":1791883149383,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,5,9]],"date-time":"2013-05-09T00:00:00Z","timestamp":1368057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A lower\u2010pitched voice is one of the most common voice alterations after thyroidectomy without laryngeal nerve injury. The aim of this study was to evaluate the acoustic and stroboscopic changes and the treatment outcomes in patients with a lower\u2010pitched voice with the goal of eventually establishing a therapeutic guideline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with a lower\u2010pitched voice were selected according to the results of acoustic analysis among thyroidectomized patients. According to their pitch\u2010gliding ability, patients were classified into a \u201cgliding group\u201d and \u201cnongliding group,\u201d and direct voice therapy was performed. For those who did not respond, indirect voice therapy with subsequent identical direct voice therapy was performed. Video\u2010stroboscopy, acoustic and perceptual analysis, and subjective analysis using a questionnaire were performed before and after treatment. The results of the two groups were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty patients were enrolled. Decreased vocal cord tension was the most common stroboscopic finding in these patients. After direct voice therapy, 87 % of patients in the gliding group showed restoration of pitch 2\u00a0months after thyroidectomy. None of the patients in the nongliding group showed improvement. After indirect voice therapy and subsequent direct voice therapy, these nonresponders finally showed improvement 4.5\u00a0months after thyroidectomy. Several characteristic stroboscopic findings of the nongliding group were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The pitch\u2010gliding ability and several specific stroboscopic findings were predictive of a response to direct voice therapy. Based on these findings, an individualized therapeutic approach could be applied, and the pitch of patients with a lower\u2010pitched voice after thyroidectomy was restored earlier than expected.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-2062-1","type":"journal-article","created":{"date-parts":[[2013,5,8]],"date-time":"2013-05-08T17:10:05Z","timestamp":1368033005000},"page":"1940-1950","source":"Crossref","is-referenced-by-count":19,"title":["Therapeutic Approach to Patients With a Lower\u2010Pitched Voice After Thyroidectomy"],"prefix":"10.1002","volume":"37","author":[{"given":"Inn\u2010Chul","family":"Nam","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Seoul St. Mary\u2019s Hospital, The Catholic University of Korea 505 Banpo\u2010dong, Seocho\u2010gu 137\u2010040 Seoul South 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