Association of Fraility with Post thyroidectomy alterations in Voice, Swallowing, and Quality of Life

项目摘要 该项目旨在评估虚弱与手术后声音、吞咽和呼吸功能改变的相关性。 老年人甲状腺切除术后的生活质量。具体地说，目标1是评估 甲状腺切除术对老年人发声、吞咽和生活质量的影响。文献表明，这些 在较年轻的患者中，改变发生的频率相对较高。我们的目标是量化频率和 声音、吞咽和生活质量的变化幅度使用主观评估与调查和半 有组织地对病人进行面谈。此外，我们的目标是将这与从语音中获得的客观数据相关联- 使用视频频闪检查和视频透视检查进行语言病理评估。在目标2中，我们将探索 脆弱表型与术前发现、甲状腺特异标记物和术后的相关性 甲状腺切除术后嗓音改变、吞咽或生活质量下降。除了探索脆弱对人类的影响 预测这些变化并确定高危人群，我们还将探索甲状腺或喉部的效用 特定的标记，以增强脆弱性的预测能力。在目标3中，我们希望研究Pre-2的作用 手术干预包括气管牵引练习和发声疗法，以减少 手术后改变的影响。我们将随机对患者进行干预或常规护理，并评估 甲状腺切除术后改变的频率。这项工作代表了一种跨学科的方法来建立 老年人甲状腺切除术后嗓音和吞咽的变化，这些因素的影响 生活质量的变化，以及减少手术后残疾的尝试。这项研究的发现将告诉我们 2个未来临床试验的设计目的是：1)评估减少手术的术前干预措施 甲状腺切除术后的残疾和2)创建一个患者报告的结果测量工具，专门用于 接受甲状腺切除手术的老年人。

Project Summary This project aims to evaluate the association of frailty with post-operative changes in voice, swallowing, and quality of life following thyroidectomy in older adults. Specifically, Aim 1 is to evaluate the effect of thyroidectomy on voice, swallowing, and quality of life in older adults. The literature suggests that these alterations occur at a relatively high frequency in younger patients. We aim to quantify frequency and magnitude of changes in voice, swallowing, and QOL using subjective assessment with surveys and semi- structured patient interviews. Additionally we aim to correlate this with objective data obtained from speech- language pathology evaluations using videostroboscopy and videofluoroscopy. In Aim 2, we will explore the associations between a frailty phenotype with pre-operative findings, thyroid-specific markers, and post- thyroidectomy alterations in voice, swallowing or decline in QOL. In addition to exploring the role of frailty to predict these alterations and identify a high-risk group, we will also explore the utility of thyroid or laryngeal specific markers to augment the predictive power of frailty. In Aim 3, we hope to investigate the role of pre- operative interventions including tracheal traction exercises and voice therapy to reduce the incidence of impact of post-operative alterations. We will randomize patients to intervention or usual care and evaluate the frequency of alterations after thyroidectomy. This work represents an interdisciplinary approach to establish alterations in voice and swallowing that occur after thyroidectomy in older individuals, the impact of these changes on quality of life, and an attempt to reduce post-surgical disability. Findings from this study will inform the design of 2 future clinical trials aimed at 1) evaluating pre-operative interventions to reduce surgical disability after thyroidectomy and 2) creating a patient-reported outcome measurement tool specifically for older adults undergoing thyroidectomy.