Thyroid gland surgery
and parathyroid gland surgery
Professor José SANTINI (MD-PhD)
Thyroid and Head and Neck Surgery Unit, Saint George Hospital, Nice, France
Corresponding Member of the American Thyroid Association
Langue / Language
Francais FR / English EN
Patient information website on the surgery of thyroid and parathyroid glands
Updated April 4, 2024
Speech therapy care
If your voice remains altered a week after the procedure, talk to your surgeon.
He will examine your vocal cords and you will then be prescribed speech therapy.
It is important to begin this treatment quickly with a specialized speech therapist.
in vocal disorders to ensure faster vocal recovery.
Why isn’t my voice like before?
It may be asimple passing hoarseness for a few days, linked to the presence of the intubation tube in the larynx during the procedure. Speech therapy will then aim to help you soften the vocal cords, reduce edema if it exists and introduce behavior to prevent vocal straining.
More rarely (2 to 3% of cases), the vocal cord nerve may have suffered slight trauma resulting invocal cord paralysis which will generate incomplete closure of the vocal cords during phonation and swallowing. Your voice will lack power and will appear more or less breathy and tired. The cough may be altered and lack effectiveness. In addition, there may be misdirection when swallowing liquids. This paralysis is generally transient but it is often difficult to predict the recovery time. The objective of speech therapy treatment will then be to restore good alignment of the vocal cords through the practice of specific exercises and laryngeal manipulations. It also aims to prevent compensatory vocal forcing from setting in and to prevent false feeding routes if they exist.
It can also exista vocal cord tension defect which causes a loss of high-pitched sounds and power of the voice. Speech therapy rehabilitation will then aim to recover the lengthening of the vocal cords and the elevation of the larynx responsible for high-pitched sounds. If scar adhesions hinder the elevation of the larynx in the acute range or for swallowing, your speech therapist can also soften this scar through massage, if this has not already been done by a physiotherapist.
How can I optimize my vocal environment after the intervention?
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Avoid speaking in noise, in an environment that is too dry (be careful of air conditioners and heaters).
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Avoid tobacco because it dries out and irritates the vocal cords.
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Practice nose washes and inhalations to keep the mucous membrane clean and hydrated.
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Hydrate yourself by drinking plenty of water at room temperature because the air leak caused by cord paralysis or temporary irritation tends to dry out the laryngeal mucosa.
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Treat your gastroesophageal reflux if you have it and apply basic health and diet rules.
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Reduce the consumption of tea, coffee, alcohol (especially white wine and champagne).
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Get enough sleep because sleep affects the recovery of your vocal cords and muscles in their entirety.
How can I save my voice after surgery?
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Do not whisper, but use a soft, sonorous voice, without forcing the intensity or putting yourself under tension. You must speak, otherwise the vocal cords risk becoming asthenic like any other muscle in the body.
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Listen to your vocal limits, both in terms of intensity and duration. If you feel like you're straining, speak less loudly and play more on good articulation face-to-face. Forcing would only induce a harmful habit that is difficult to correct later.
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Keep voice recovery time during the day, especially after using the voice loudly or for prolonged periods.
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Be wary of the telephone which encourages vocal forcing and prefer written messages or emails for a while when possible.
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Avoid clearing your throat to remove phlegm as this only makes it more intense. Prefer less irritating actions such as coughing lightly, swallowing saliva or drinking a sip of water.
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Favor face to face so that your interlocutor can rely on the movements of your lips.
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Make shorter sentences by regularly repeating your breathing by relaxing the ribs and stomach.
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Find a flexible, upright posture without projecting your neck forward when speaking.
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Find the voice pitch that costs you the least amount of effort and stay in that comfort zone.
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Amplify your articulation by opening your mouth more vertically when you speak.
How long does the support last?
The duration of rehabilitation is extremely variable (a few weeks to several months) and will depend on the reasons for your vocal disorder and your recovery. The early treatment, your regularity in practicing the exercises; are factors of success. Also, do not delay in making an appointment with the speech therapist as soon as the surgeon recommends it.
What should I do if I swallow wrong?
If you notice swallowing problems when you drink, you can implement a few simple strategies:
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Swallow while looking at your navel, head down and chin tucked. If paralysis or paresis of the cord has been noted, you can also turn your head to the side of the injured cord.
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Prefer sparkling water to still water because it will stimulate your receptors more and you will risk less misdirection.
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Prefer iced or hot liquids rather than those at room temperature.
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Avoid drinking with your head back in continuous sips and instead drink in small sips, taking your time. Drinking through a straw can help you with this.
If you go wrong, don't panic. Cough first to get the liquid out. Then exhale slowly through your mouth and inhale through your nose in very small intakes of air until the coughing fit disappears.