Voice rehabilitation after thyroid cancer surgery: a narrative review of current evidence and clinical practice
Year: 2026
Type: review
Abstract: Background and Objective: Voice impairment is common after thyroid cancer surgery and can significantly affect quality of life, even in the absence of recurrent laryngeal nerve (RLN) injury. Voice rehabilitation has been recognized as beneficial, but current guidelines lack thyroid cancer-specific protocols regarding assessment, timing, intensity, and long-term follow-up. This review critically appraises current evidence on voice rehabilitation after thyroid cancer surgery to inform clinical decision-making and identify practice gaps. Methods: PubMed and Web of Science Core Collection were searched from January 1, 2015 to July 31, 2026. Eligible studies included clinical decisions, guidelines, expert consensus, systematic reviews, and original clinical studies addressing postoperative voice assessment, rehabilitation, or follow-up in adults after thyroidectomy for thyroid cancer. Evidence was synthesized narratively across nine domains: mechanisms and natural history; assessment tools and timing; timing and risk stratification; voice therapy; surgical rehabilitation; special populations; tele-rehabilitation and long-term follow-up; multidisciplinary collaboration and patient education; and evidence gaps. Key Content and Findings: Post-thyroidectomy voice dysfunction is multifactorial and heterogeneous. Most patients improve within 3-6 months, but approximately 20% have persistent dysfunction at 1 year. Multidimensional assessment combining patient-reported outcomes, perceptual evaluation, acoustic measures, and laryngeal imaging is recommended. Early voice therapy within 4 weeks may improve outcomes. Surgical rehabilitation, including injection laryngoplasty (IL), laryngeal framework surgery, and recurrent laryngeal nerve reinnervation (RLNR), is indicated for persistent paralysis. Tele-rehabilitation and multidisciplinary care are promising but understudied. Evidence remains limited by heterogeneity, small sample sizes, and lack of standardized outcome measures. Conclusions: Voice rehabilitation after thyroid cancer surgery should be individualized, multidimensional, and initiated early for high-risk patients. Future research should prioritize core outcome sets (COSs), multicenter randomized trials, and validation of tele-rehabilitation and digital tools to improve long-term voice outcomes.
Source: Gland Surgery
Institutions: Jiangsu Cancer Hospital, Nanjing Medical University
Language: English
Topic: Voice and Speech Disorders
Subfield: Speech and Hearing
Field: Health Professions
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223850683