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术后声音，吞咽和 老年人甲状腺切除术后的生活质量。具体而言，目标1是评估 甲状腺切除术对老年人声音、吞咽和生活质量的影响。文献表明，这些 在较年轻的患者中以相对高的频率发生改变。我们的目标是量化频率和 使用调查和半定量主观评估评估的声音、吞咽和QOL变化幅度 结构化患者访谈。此外，我们的目标是将其与从语音中获得的客观数据相关联- 使用视频频闪镜检查和视频荧光透视进行语言病理学评估。在目标2中，我们将探讨 虚弱表型与术前发现、甲状腺特异性标志物和术后 甲状腺切除术改变声音、吞咽或QOL下降。除了探索脆弱的作用， 为了预测这些改变并确定高危人群，我们还将探讨甲状腺或喉功能的实用性。 特定的标记来增强虚弱的预测能力。在目标3中，我们希望研究预处理的作用。 手术干预，包括气管牵引练习和语音治疗，以减少 术后变化的影响。我们将患者随机分为干预组或常规治疗组， 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， 在老年人甲状腺切除术后发生的声音和吞咽的改变，这些影响 生活质量的改变，以及减少术后残疾的尝试。这项研究的结果将告知 设计2项未来临床试验，旨在1）评价术前干预以减少手术 甲状腺切除术后残疾和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.