Table. Patient-Perceived Impaired Communication Over the First Postoperative Year.

Time Point	Quotation
Baseline (n = 2)	I am very concerned about what voice I’m going to have when I come out…am I going to have a voice? Because that’s my career (patient 6).
	The concerns are…at any time you go in for a procedure like this you run those small risks of something happening, could there be vocal cord damage, could I lose my voice, could I, even if I don’t lose it, could there be damage? That concerns me…I’d say of everything that’s what I’m most worried about (patient 28).
2 wk (n = 24)	It’s literally such an effort right now for me to talk…my voice isn’t strong like it was before…before the surgery, I wouldn’t have even thought about it…after the surgery it became much more relevant for me (patient 9).
	When I was talking…I got to the point where I just didn’t want to talk anymore…I was tired from, it’s hard to explain I think just because…I’ve never had that happen in my life. It’s probably the only time it’ll ever happen (patient 11).
	A lot of people that have been calling me…especially after the surgery, I definitely didn’t speak to people on the phone…because of the hoarseness. There were times when I wanted to talk, but I couldn’t (patient 13).
6 wk (n = 17)	With my job, sometimes my voice gets strained and tired, and it becomes hard for me to talk, and I can’t manage the classroom…I can’t teach the material then, and that’s my livelihood…I need to have my voice (patient 19, glottic insufficiency).
	That I don’t have a voice, yeah-that’s a major problem (patient 27, right VF immobility).
	Physically I feel good, it’s just so stressful because it’s taken away my livelihood. I work 14, 16 hour days and 90% of my job is talking on the phone, talking to clients, I can’t answer my phone…so it’s very frustrating to not be able to communicate well...it’s an effort to talk (patient 47, right VF paralysis, left VF paresis).
6 mo (n = 11)	[My voice] is just not perfect yet, I mean it’s very minimal, and I feel like it’s normal now in comparison to…immediately just after the surgery (patient 6).
	My voice becomes weak by itself...I feel like I’m screaming or yelling, but other people can’t hear me (patient 12).
	I didn’t even know what to expect…and I think at the beginning I was surprised at how different my voice was, and how even if other people couldn’t hear it, it felt very different…I really didn’t have an expectation of what that was going to be like (patient 33).
1 y (n = 15)	By the time I get home, I could go the rest of the night without using it [my voice] …the joys of living alone and texting I guess...I don’t have to use it [my voice] until the next morning when I get to school again (patient 2).
	There have been times where I’ve apologized to people saying, hey sorry my voice is, is sounding a little bit rough, or hey I feel a lot better than I sound…I’ve said that many times (patient 5).
	I did a lot of community theater…I was a soloist, and…I can’t even think about doing that…because I’m afraid of what came out…I don’t know what my voice is gonna do…that’s very frustrating because I know what it [my voice] sounds like and I don’t like it (patient 16).

Abbreviation: VF, vocal fold.