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This study was accredited by the institutional assessment board of our center (KUGH IRB 12-138).2.2. Surgical Procedure of ThyroidectomyThyroidectomy was performed according for the standardized typical technique. The strap muscle groups were divided along the linea alba and separated from your thyroid gland. Lateral factor from the YO-01027 APPL thyroid was exposed byMinocycline HCl ligation of the middle thyroid vein and lateral retraction of the strap muscular tissues. The recurrent laryngeal nerve was identified in all instances on the lower pole of thyroid, and dissection on the gland was performed along the nerve from caudal to cranial route. Superior pole with the gland was exposed by pulling the thyroid gland towards inferior and medial direction and retracting the strap muscle tissue laterally. At this time, the surgeon made a decision irrespective of whether to minimize the ST muscle or not.

If surgical exposure with the upper end in the superior pole was inadequate, medial edge of ST muscle (about 2cm) was lower using Harmonic Curved Shears (Harmonic Concentrate; Johnson & Johnson Medical, Cincinnati, OH, USA) in the laryngeal headAZD1152HQPA where the muscle inserts along the thyroid cartilage (Figure 1). Reapproximation from the divided muscle was not performed. After removing the bilateral thyroid gland, the strap muscles have been reapproximated at the midline, and meticulous skin closure was carried out.Figure 1Partial cutting of sternothyroid muscle during thyroidectomy. (a) Superior pole of right thyroid gland covered by sternothyroid muscle. (b) Cutting the medical 2cm of sternothyroid muscle. (c) Good publicity of your superior pole.2.3.

Acoustic and Aerodynamic AnalysisAcoustic analysis was performed by a speech pathologist utilizing Computerized Speech Lab (CSL, KAY Electrics Corp, Model 4500, NJ, USA). Voice range profile (VRP) was examined from phonation in the lowest towards the highest note after adequate inspiration. The software screen presented the notes on a piano keyboard demonstrating the minimum frequency (Fmin ), maximum frequency (Fmax ), and the range of frequency (Frange). The minimum intensity (Min-dB), maximum intensity (Max-dB), and the range of intensity (dB-range) have been also assessed during the phonation. Applying the multidimensional voice program (MDVP), the fundamental frequency (F0), jitter, shimmer, and noise-to-harmonic ratio (NHR) have been evaluated.

The patient was seated on a chair and told to say ��a�� for 3 seconds at a comfortable level of effort, and the voice was recorded with a microphone 10cm away from your lips. Maximal phonation time (MPT) was assessed during phonation of ��a�� at a constant pitch and intensity after full inspiration. The maximum value among three consecutive examinations of MPT was taken. 2.4. Perceptual AnalysisPerceptual analysis was conducted by a single expert speech therapist of our center employing a modified four scale from the GRBAS scale proposed by Hirano [11].