{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T23:14:40Z","timestamp":1771370080953,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,11,28]],"date-time":"2020-11-28T00:00:00Z","timestamp":1606521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,11,28]],"date-time":"2020-11-28T00:00:00Z","timestamp":1606521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,11,28]],"date-time":"2020-11-28T00:00:00Z","timestamp":1606521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Eastern Finland (UEF) including Kuopio University Hospital"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to evaluate the reliability of clinician\u2010based perceptual assessment of voice and computerized acoustic voice analysis as screening tests for vocal fold paresis or paralysis (VFP) after thyroid and parathyroid surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective study of 181 patients undergoing thyroid or parathyroid procedure with pre and postoperative laryngoscopic vocal fold inspection, perceptual voice assessment using grade, roughness, breathiness, asthenia, and strain (GRBAS) scale and acoustic voice analysis using the multi\u2010dimensional voice program (MDVP). Patients were divided into 2\u00a0groups for comparison; those with new postoperative VFP and those without. Potential screening tools were evaluated using the receiving operating characteristic (ROC) analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen (6.6%) patients had a new postoperative VFP. Postoperative GRBAS scores were significantly (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) higher in patients with VFP compared to those without. However, there were no statistically significant differences in MDVP values between the groups. Postoperative GRBAS grade score (cut off\u2009&gt;\u20090) had the best sensitivity, 93%, for predicting VFP, but the specificity was only 50%. Postoperative jitter (cut off\u2009&gt;\u20091.60) in MDVP had a good specificity, 90%, but only 50% sensitivity. Combining all the GRBAS and MDVP variables with <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05\u00a0in the ROC analysis yielded a test with 100% sensitivity and 55% specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Physician\u2010based perceptual voice assessment has a high sensitivity for detecting postoperative VFP, but the specificity is poor. The risk of VFP is low in patients with completely normal voice at discharge. However, routine laryngoscopy after thyroid and parathyroid surgery is still the most reliable exam for VFP screening.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05863-x","type":"journal-article","created":{"date-parts":[[2020,11,28]],"date-time":"2020-11-28T20:02:31Z","timestamp":1606593751000},"page":"765-773","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Perceptual Assessment and Acoustic Voice Analysis as Screening Tests for Vocal Fold Paresis After Thyroid or Parathyroid Surgery"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6220-9932","authenticated-orcid":false,"given":"Maria","family":"Heikkinen","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head &amp; Neck Surgery Kuopio University Hospital PL 100 70029 Kuopio Finland"},{"name":"Institute of Clinical Medicine University of Eastern Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elina","family":"Penttil\u00e4","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head &amp; Neck Surgery Kuopio University Hospital PL 100 70029 Kuopio Finland"},{"name":"Institute of Clinical Medicine University of Eastern Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mari","family":"Qvarnstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Phoniatrics Kuopio University Hospital Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimmo","family":"M\u00e4kinen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine University of Eastern Kuopio Finland"},{"name":"Heart Center Kuopio University Hospital Kuopio 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