Voice change is a common complaint after thyroid surgery and has a significant impact on quality of life. The Korean Society of Laryngology, Phoniatrics and Logopedics assembled a task force to establish guideline recommendations on education, care, and management related to thyroid surgery. The guideline recommendations encompass preoperative voice education, management of anticipated voice change during surgery, and comprehensive voice care after thyroid surgery, and include in-depth information and up-to-date knowledge based on validated literature. The committee constructed 14 key questions (KQs) in three categories—preoperative (KQ 1–2), intraoperative (KQ 3–8), and postoperative (KQ 9–14) management—and developed 18 evidence-based recommendations. The Delphi survey reached an agreement on each recommendation. A detailed evidence profile is presented for each recommendation. The level of evidence for each recommendation was classified as high-quality, moderate-quality, or low-quality. The strength of each recommendation was designated as strong or weak considering the level of evidence supporting the recommendation. The guidelines are primarily targeted toward physicians who treat thyroid surgery patients and speech-language pathologists participating in patient care. These guidelines will also help primary care physicians, nurses, healthcare policymakers, and patients improve their understanding of voice changes and voice care after thyroid surgery.

Vocal fold leukoplakia, white plaque on the epithelium, has the potential for malignant transformation regardless of dysplasia grade. It is treated with different laser types (CO₂ or angiolytic) and various techniques (vaporization, stripping, or excision); however, only a few studies exist regarding comparative laser surgery results. This study was conducted to investigate clinical outcomes of CO₂ versus angiolytic laser microdissection with regard to long-term disease control and voice preservation in vocal fold leukoplakia. Seventy patients with vocal fold leukoplakia treated by CO₂ or angiolytic laser (pulsed dye laser or potassium titanyl phosphate) were identified retrospectively. Data regarding patient characteristics, treatment details, treatment outcomes including disease control (recurrence and progression) and the Voice Handicap Index, GRBAS scale, and acoustics were evaluated. The mean follow-up duration after initial treatment was 32 ± 26 months. The study group comprised 14 patients who underwent CO₂ laser microflap excision and 56 who underwent angiolytic laser stripping. Of the patients treated with CO₂ laser, 11 (79%) had no recurrence and three (21%) showed recurrent leukoplakia, of which one patient (7%) showed histologic grade progression. Of patients who underwent angiolytic laser stripping, 12 had disease recurrence (21%), among whom three (5%) showed disease progression. Laser surgery type, disease extent, and histologic grade showed no significant differences in recurrence or progression rates. The postoperative Voice Handicap Index significantly improved (P = .03) and the G score significantly decreased (P < .001) in the angiolytic laser treatment group. In contrast, the Voice Handicap Index increased postoperatively in the CO₂ laser group (P = .046). The long-term recurrence or progression rates were not significantly different between angiolytic and CO₂ laser treatment. The angiolytic laser stripping group showed better voice preservation compared with the CO₂ laser group. Angiolytic laser stripping is suggested as an effective treatment option for vocal fold leukoplakia with comparable disease control and better voice preservation.

Objectives: The purpose of the present study was to construct local normative data for cepstral and spectral measures in Korean adults without voice impairments by using vowel phonation and passage reading tasks, and to investigate whether those measures differ according to gender and the measurement positions in a passage. Furthermore, the correlation of the measures derived by different tasks was also explored. Methods: One hundred and forty-four community-dwelling adults (age-matched 72 males and 72 females) without speech or language disorders participated in the study. Participants were asked to produce the Korean vowel /a/ and to read the Korean standard passage 'Ga-eul'. Cepstral and spectral measures were obtained for each vowel and sentence sample in front and rear positions of the passage using the Analysis of Dysphonia in Speech and Voice program. For sentence samples, cepstral measures were compared according to gender and position. Results: Males showed significantly higher CPP, CPPmax, CPPmin, and σCPP in vowel production tasks, while females showed higher CPP F0 and CPP/Avg. In the passage reading task, a significant interaction effect between gender and position was shown for CPP, σCPP, maximum L/H ratio, CPP F0, and σCPP F0. Males showed higher CPPmax and L/H ratio, while females showed higher CPPmin and CPP/Avg. The minimum L/H ratio was higher for the front position, while the σL/H ratio and regression slope were higher for the rear position. Conclusion: The current data could contribute to the diagnosis of voice problems in the Korean population through clinical practice and research, although the differences between tasks should be taken into consideration.

Objective: This paper sought to examine perceptual and acoustic characteristics in Korean female voices, focusing on the ‘breathy' quality as a function of aging. In addition, we aimed to investigate if the three selected measures, H1-H2, H1-A1, and H1-A3, demonstrated any changes along a sustained vowel production. Participants and Methods: A total of 42 participants were assigned to two age groups, young women and elderly women. All participants were asked to sustain /a/ as long and as steadily as possible. Perceptual judgments of breathiness were made on the GRBAS scale and by a direct magnitude estimation technique, while three acoustic parameters, H1-H2, H1-A1, and H1-A3, were measured at five measurement time points during the sustained vowel test. Results: Results indicated that the H1-H2 and H1-A1 values were significantly lower for elderly women compared to young women, although no difference in the perceptual estimation of breathiness was found between the age groups. Among the acoustic measures, only H1-A1 was significantly regressed against the perceptual estimate of breathiness. In addition, no significant acoustic difference in the measures was found across the five measurement points. Conclusion: Our findings suggest that the aging voice might not be universally characterized by the breathy quality, which hints at the need for further research on ethnic diversity in vocal quality.