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Mowat A, Sandhar P, Chan J, De M. Patient-perceived dysphagia and voice change post thyroid surgery: a telephone questionnaire. J Laryngol Otol 2024; 138:656-660. [PMID: 38057965 DOI: 10.1017/s0022215123002219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
OBJECTIVE This study analyses the incidence of subjectively experienced dysphagia and voice change in post-thyroidectomy and parathyroidectomy patients without recurrent laryngeal nerve palsy. METHODS A total of 400 patients were invited to participate in a telephone questionnaire based on the Dysphagia Handicap Index and Voice Handicap Index. At 6-24 months following surgery, participants were divided into: post-thyroid surgery (total, hemi-, parathyroidectomy) groups and controls (other ENT procedures). A total of 254 responses were received (127 following thyroid surgery, 127 controls). RESULTS Twenty-two per cent of post-thyroidectomy patients had a Voice Handicap Index score of more than 3, compared to 15 per cent of parathyroid patients and 4 per cent of controls. The mean Dysphagia Handicap Index score for patients post thyroidectomy and hemi-thyroidectomy was 2.0. Parathyroidectomy patients had a mean Dysphagia Handicap Index score of 1.3, higher than controls at 1.0. CONCLUSION Dysphagia and voice alteration are common following thyroid surgery, even in the absence of recurrent laryngeal nerve injury. Both deficits occur more frequently following thyroid surgery than parathyroid surgery.
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Affiliation(s)
- Andrew Mowat
- Otolaryngology, Heartlands Hospital, Bordesley Green, Birmingham, UK
| | - Pardip Sandhar
- Otolaryngology, Heartlands Hospital, Bordesley Green, Birmingham, UK
| | - Jacqueline Chan
- Otolaryngology, Heartlands Hospital, Bordesley Green, Birmingham, UK
| | - Mriganka De
- Otolaryngology, Heartlands Hospital, Bordesley Green, Birmingham, UK
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Magalhães DDDD, Bandeira JDF, Costa BOID, Santos AS, Santos RV, da Silva HJ, Junior HVM, Pernambuco L. Hyoid Bone Movement During Swallowing in Female Thyroidectomy Patients: A Kinematic Ultrasound Study. Dysphagia 2024:10.1007/s00455-024-10676-4. [PMID: 38436670 DOI: 10.1007/s00455-024-10676-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/23/2024] [Indexed: 03/05/2024]
Abstract
The aim of this study was to investigate the measures of displacement, time and velocity of hyoid bone movement in female thyroidectomy patients. Fifty-eight ultrasound videos of 29 women during swallowing were analyzed. The sample was divided into experimental group (EG), composed of 12 women following total or partial thyroidectomy; and control group (CG) of 17 healthy women. The kinematic measures of displacement, time and velocity of hyoid bone displacement were tracked during swallowing of 10 ml of liquid (water) and 10 ml of thickened liquid (honey) in both groups for comparisons. Additional analysis included bolus consistency effect and relationship with clinical characteristics. Ultrasound videos were analyzed according to a standardized protocol using ImageJ software. Displacement, time and velocity of hyoid movement during swallowing of 10 ml of liquid or thickened liquid were not statistically different between female thyroidectomy patients and healthy women. There is no bolus consistency effect on kinematic measures in both groups, but among thyroidectomy patients, velocity of hyoid bone movement is significantly faster in those with swallowing complaints.
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Affiliation(s)
- Desiré Dominique Diniz de Magalhães
- Graduate Program in Speech, Language and Hearing Sciences (PPgFon-UFPB), Universidade Federal da Paraíba (UFPB), Campus I s/n, Cidade Universitária, João Pessoa, PB, 58051-900, Brazil
| | - Jayne de Freitas Bandeira
- Graduate Program in Speech, Language and Hearing Sciences (PPgFon-UFPB), Universidade Federal da Paraíba (UFPB), Campus I s/n, Cidade Universitária, João Pessoa, PB, 58051-900, Brazil
| | - Bianca Oliveira Ismael da Costa
- Graduate Program in Speech, Language and Hearing Sciences (PPgFon-UFPB), Universidade Federal da Paraíba (UFPB), Campus I s/n, Cidade Universitária, João Pessoa, PB, 58051-900, Brazil
| | - Ary Serrano Santos
- Lauro Wanderley University Hospital (HULW/EBSERH), Universidade Federal da Paraíba (UFPB), R. Tabelião Stanislau Eloy, 585, Castelo Branco, João Pessoa, PB, 58050-585, Brazil
| | - Ricardo Vieira Santos
- Lauro Wanderley University Hospital (HULW/EBSERH), Universidade Federal da Paraíba (UFPB), R. Tabelião Stanislau Eloy, 585, Castelo Branco, João Pessoa, PB, 58050-585, Brazil
| | - Hilton Justino da Silva
- Department of Speech, Language and Hearing Sciences, Universidade Federal de Pernambuco (UFPE), Cidade Universitária, Recife, PE, 50670901, Brasil
| | - Hipólito Virgílio Magalhães Junior
- Department of Speech, Language and Hearing Sciences, Universidade Federal do Rio Grande do Norte (UFRN), Rua General Gustavo Cordeiro de Farias s/n, Petrópolis, Natal, RN, 59012-570, Brazil
| | - Leandro Pernambuco
- Graduate Program in Speech, Language and Hearing Sciences (PPgFon-UFPB), Universidade Federal da Paraíba (UFPB), Campus I s/n, Cidade Universitária, João Pessoa, PB, 58051-900, Brazil.
- Department of Speech, Language and Hearing Sciences, Universidade Federal de Pernambuco (UFPE), Cidade Universitária, Recife, PE, 50670901, Brasil.
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Crepeau PK, Sutton W, Sahli Z, Fedorova T, Russell JO, Zeiger MA, Bandeen-Roche K, Walston JD, Morris-Wiseman LF, Mathur A. Prevalence and risk factors for dysphagia in older adults after thyroid and parathyroid surgery. Surgery 2024; 175:99-106. [PMID: 37945476 PMCID: PMC10841879 DOI: 10.1016/j.surg.2023.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/03/2023] [Accepted: 04/27/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND We aimed to determine the prevalence and risk factors for dysphagia in adults 65 years and older before and after thyroidectomy or parathyroidectomy. METHODS We performed a longitudinal prospective cohort study of older adults undergoing initial thyroidectomy or parathyroidectomy. We administered the Dysphagia Handicap Index questionnaire preoperatively and 1, 3, and 6 months postoperatively. We compared preoperative and postoperative total and domain-specific scores using paired t tests and identified risk factors for worse postoperative scores using multivariable logistic regression. RESULTS Of the 175 patients evaluated, the mean age was 71.1 years (range = 65-94), 73.7% were female, 40.6% underwent thyroidectomy, 57% underwent bilateral procedures, and 21.1% had malignant diagnoses. Preoperative swallowing dysfunction was reported by 77.7%, with the prevalence 22.4% greater in frail than robust patients (P = .013). Compared to preoperative scores, 43.4% and 49.1% had worse scores at 3 and 6 months postoperatively. Mean functional domain scores increased by 62.3% at 3 months postoperatively (P = .007). Preoperative swallowing dysfunction was associated with a 3.07-fold increased likelihood of worse functional scores at 3 months. Whereas frailty was associated with preoperative dysphagia, there was no association between worse postoperative score and age, sex, race, frailty, body mass index, smoking status, gastroesophageal reflux disease, comorbidity index, malignancy, surgical extent, or type of surgery. CONCLUSION Adults 65 years and older commonly report swallowing impairment preoperatively, which is associated with a 3.07-fold increased likelihood of worsened dysphagia after thyroid and parathyroid surgery that may persist up to 6 months postoperatively.
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Affiliation(s)
- Philip K Crepeau
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Whitney Sutton
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Zeyad Sahli
- Department of Surgery, The University of Virginia Health System, Charlottesville, VA
| | - Tatiana Fedorova
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jonathon O Russell
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Martha A Zeiger
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Karen Bandeen-Roche
- Johns Hopkins Older Americans Independence Center and the Center on Aging and Health, Johns Hopkins University, Baltimore, MD; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jeremy D Walston
- Johns Hopkins Older Americans Independence Center and the Center on Aging and Health, Johns Hopkins University, Baltimore, MD; Division of Geriatrics and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | | | - Aarti Mathur
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
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Lee SY, Ryu SR, Yun BR, Ji YB, Song CM, Tae K. Patient-reported swallowing outcomes after transoral robotic thyroidectomy: Comparison with conventional transcervical thyroidectomy. Head Neck 2024; 46:64-73. [PMID: 37877746 DOI: 10.1002/hed.27557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/24/2023] [Accepted: 10/12/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the swallowing outcomes after transoral robotic thyroidectomy (TORT) and compare them with those of conventional transcervical thyroidectomy. METHOD We enrolled 146 patients who underwent thyroidectomy (73 TORT; 73 conventional approach). We prospectively analyzed swallowing outcomes using the Swallowing Impairment Index-6 (SIS-6) questionnaire, a patient-reported measure, before and 1, 3, and 6 days; 1, 3, and 6 months; and 1 year after surgery. Propensity score-matched analysis was performed using three covariates: age, sex, and extent of thyroidectomy. RESULTS SIS-6 scores worsened significantly immediately after surgery and progressively recovered 1 year postoperatively in both groups. Propensity score matching generated two matched groups of 22 patients each. In the propensity score-matched samples, the SIS-6 scores did not differ between the TORT and conventional groups, except at 1 day postoperatively. CONCLUSION Patient-reported swallowing outcomes of TORT were comparable to those of the conventional transcervical procedure.
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Affiliation(s)
- Seung Yeol Lee
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
| | - Soo Rack Ryu
- Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, South Korea
| | - Bo Ram Yun
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
| | - Yong Bae Ji
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
| | - Chang Myeon Song
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
| | - Kyung Tae
- Department of Otolaryngology - Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
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5
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Lippi L, Turco A, Moalli S, Gallo M, Curci C, Maconi A, de Sire A, Invernizzi M. Role of Prehabilitation and Rehabilitation on Functional Recovery and Quality of Life in Thyroid Cancer Patients: A Comprehensive Review. Cancers (Basel) 2023; 15:4502. [PMID: 37760472 PMCID: PMC10526253 DOI: 10.3390/cancers15184502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND This narrative review aims to provide a comprehensive overview of the current prehabilitation and rehabilitation strategies for thyroid cancer survivors to optimize functional outcomes and enhance their quality of life. METHODS The review follows the SANRA quality criteria and includes an extensive literature search conducted in PubMed/Medline, Web of Science, and Scopus. RESULTS The review emphasizes the role of a comprehensive rehabilitation approach in targeting the different domains that generate disability in thyroid cancer patients. In this context, physical activity, range of motion exercises, myofascial release, joint mobilization, and postural exercises are crucial for improving functional outcomes and reducing treatment-related discomfort and disability. Moreover, tailored rehabilitative management addressing dysphonia and dysphagia might have a positive impact on the quality of life of these patients. Despite these considerations, several barriers still affect the implementation of a multimodal rehabilitative approach in common clinical practice. Thus, sustainable and effective strategies like digital innovation and patient-centered approaches are strongly needed in order to implement the rehabilitative treatment framework of these subjects. CONCLUSIONS This narrative review provides valuable insights into the current prehabilitation and rehabilitation strategies to treat thyroid cancer survivors, addressing physical, psychological, and vocational needs to optimize functional outcomes and enhance their quality of life.
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Affiliation(s)
- Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Alessio Turco
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
| | - Stefano Moalli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
| | - Marco Gallo
- Endocrinology and Metabolic Diseases Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy;
| | - Antonio Maconi
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
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TM R, Krishnan K, Thiagarajan S, Balaji A, Chaukar D. Results of Swallowing Assessment in the Immediate Postoperative Period in Patients Following Surgery for Thyroid Malignancies. Indian J Otolaryngol Head Neck Surg 2023; 75:1474-1479. [PMID: 37636624 PMCID: PMC10447709 DOI: 10.1007/s12070-023-03608-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/17/2023] [Indexed: 03/06/2023] Open
Affiliation(s)
- Rukmangathan TM
- MASLP Speech and Swallowing Therapist Division. of Head & Neck Oncology, Tata Memorial Hospital, Mumbai, India
| | - Kartik Krishnan
- Division of Head & Neck Oncology, Dept. of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Shivakumar Thiagarajan
- Division of Head & Neck Oncology, Dept. of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - Arun Balaji
- Mr. Arun Balaji MASLP Speech and Swallowing Therapist Division. of Head & Neck Oncology, Tata Memorial Centre, Mumbai, India
| | - Devendra Chaukar
- Division of Head & Neck Oncology, Dept. of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
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Depolli GT, de Oliveira GB, de Oliveira TJ, Santos MHDS, Rocha RM, Guimarães MF, Azevedo EHM. Quality of life in dysphagia and anxiety and depression symptoms pre and post-thyroidectomy. Codas 2023; 35:e20220099. [PMID: 37556687 PMCID: PMC10449093 DOI: 10.1590/2317-1782/20232022099pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 09/23/2022] [Indexed: 08/11/2023] Open
Abstract
PURPOSE To correlate the dysphagia quality of life and symptoms of anxiety and depression before and after thyroidectomy. METHODS Observational, longitudinal, prospective, and experimental study. Twenty patients participated, with a mean age of 54 years, prevalence of females (n=17; 85%) and partial thyroidectomy (n=14; 70%). All subjects underwent laryngeal visual examination and answered the MD Anderson Dysphagia Questionnaire (MDADI) and the Hospital Anxiety and Depression Scale (HADS) in three different moments: preoperatively, immediately postoperatively (maximum one week) and three months after surgery. RESULTS There was a significant difference in dysphagia quality of life for the physical and total domains in the three different moments. Regarding anxiety and depression, a statistically significant difference was observed between the scores in all domains, with a greater difference observed between the preoperative period and after 1 week. Higher values were observed in the preoperative period for mild anxiety traits, being more frequent in relation to depression, with a reduction after 1 week and an increase after three months of surgery. There was no significant correlation between the MDADI and HADS protocols. CONCLUSION Patients undergoing thyroidectomy self-report better quality of life in dysphagia and reduced anxiety/depression scores after three months of surgery. There was no correlation between anxiety, depression and quality of life in dysphagia at the moments evaluated.
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Affiliation(s)
- Gabriel Trevizani Depolli
- Departamento de Fonoaudiologia, Universidade Federal do Espírito Santo - UFES - Vitória (ES), Brasil.
| | | | - Thais Jejesky de Oliveira
- Departamento de Fonoaudiologia, Universidade Federal do Espírito Santo - UFES - Vitória (ES), Brasil.
| | | | - Ricardo Mai Rocha
- Hospital Universitário Cassiano Antônio Moraes - EBSERH - Vitória (ES), Brasil.
- Departamento de Cirurgia de Cabeça e Pescoço, Universidade Federal do Espírito Santo - UFES - Vitória (ES), Brasil.
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Yu C, Chunmei L, Caiping S. Symptoms and coping of patients with dysphagia after anterior cervical spine surgery: a qualitative study. BMC Musculoskelet Disord 2023; 24:498. [PMID: 37330488 DOI: 10.1186/s12891-023-06621-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/09/2023] [Indexed: 06/19/2023] Open
Abstract
AIM To explore the subjective symptoms, psychological characteristics and coping strategies of patients with dysphagia after anterior cervical spine surgery, so as to provide the basis for formulating strategies to help patients with dysphagia solve clinical practice problems and to improve their quality of life after surgery. METHODS Using the phenomenological research method and the purpose sampling method, semi-structured interviews were conducted with 22 participants with dysphagia at 3-time points after anterior cervical spine surgery (7 days, 6 weeks, and 6 months). RESULTS A total of 22 (10 females and 12 males) patients, with years old ranging between 33 and 78 years were interviewed. When analysing the data, the following 3 categories were extracted from the participant interviews: "Subjective symptoms, Coping style and impact on social life". The 3 categories consist of 10 sub-categories. CONCLUSIONS The results showed that swallowing-related symptoms may occur after anterior cervical spine surgery. Many patients had developed compensatory strategies to manage or reduce the burden of these symptoms, but lacked professional guidance from health care professionals. Moreover, dysphagia after neck surgery has its unique characteristics, involving the interaction of physical, emotional and social factors, which requires early screening.Healthcare professionals should provide better psychological support in the early or late postoperative period to ensure the improvement of health outcomes and patients' quality of life.
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Affiliation(s)
- Chen Yu
- Department of Urology, Xinqiao Hospital, The Army Medical University, Chongqing, 400037, China
| | - Luo Chunmei
- Department of Orthopaedics, Xinqiao Hospital, The Army Medical University, Chongqing, 400037, China
| | - Song Caiping
- Department of Office of the hospital, Xinqiao Hospital, The Army Medical University, Chongqing, 400037, China.
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Vardaxi C, Tsetsos N, Koliastasi A, Poutoglidis A, Sapalidis K, Triaridis S, Printza A. Swallowing disorders after thyroidectomy: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2022; 279:4213-4227. [PMID: 35438344 DOI: 10.1007/s00405-022-07386-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/01/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Swallowing disorders following thyroidectomy are common, even after surgery without confirmed complications. The purpose of the current systematic review is to investigate the prevalence of dysphagia at various time points after thyroidectomy, at the whole spectrum of it (total/partial, open/endoscopic, for benign/malignant disease). METHODS The literature available at PubMed, SciELO and Cochrane Library databases was reviewed, according to PRISMA guidelines, using the terms "dysphagia", "swallowing disorder", "deglutition disorder", "thyroidectomy" and "thyroid surgery" in the appropriate combinations. A quantitative synthesis of the results followed. RESULTS The systematic review of the literature resulted in 35 articles, which met the inclusion criteria and were analyzed regarding their type, sample, follow-up and results regarding post-thyroidectomy dysphagia in multiple follow-up times. A significant increase of swallowing impairment compared to baseline was recorded shortly after surgery. Dysphagia reverted to pre-operative levels 2-3 months later. Dysphagia continued to be reported in a significantly lower proportion of patients, even 1 year after surgery. No significant difference was noticed between open and endoscopic thyroid surgery at 2-3 months post-surgery. CONCLUSIONS The swallowing disorders reported after thyroidectomy should be expected, but are not always detectable through objective methods. This should not lead to underestimation of symptoms, since the patients' quality of life is negatively affected by the symptomatology.
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Affiliation(s)
- Chrysoula Vardaxi
- 1st Department of Otorhinolaryngology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
- Department of Otorhinolaryngology, "G. Papanikolaou" General Hospital, 57010, Thessaloniki, Greece
| | - Nikolaos Tsetsos
- Department of Otorhinolaryngology, "G. Papanikolaou" General Hospital, 57010, Thessaloniki, Greece
| | - Aikaterini Koliastasi
- Department of Food Science and Technology, International Hellenic University, Sindos Campus, 57400, Thessaloniki, Greece
| | - Alexandros Poutoglidis
- Department of Otorhinolaryngology, "G. Papanikolaou" General Hospital, 57010, Thessaloniki, Greece
| | - Konstantinos Sapalidis
- 3rd Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Stefanos Triaridis
- 1st Department of Otorhinolaryngology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Athanasia Printza
- 1st Department of Otorhinolaryngology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
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Del Rio P, Carcoforo P, Medas F, Bonati E, Loderer T, Koleva Radica M, Calò P. Adverse events in thyroid surgery: observational study in three surgical units with high volume/year. BMC Surg 2021; 21:352. [PMID: 34563188 PMCID: PMC8465779 DOI: 10.1186/s12893-021-01353-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 08/28/2021] [Indexed: 12/03/2022] Open
Abstract
Background Thyroid surgery, performed for benign or malignant pathologies, is one of the most frequently performed procedures and its frequency has even been increasing in recent years. Postoperative bleeding, recurrent laryngeal nerve (RLN) palsy, associated to dysphonia, dysphagia, dyspnea, and hypoparathyroidism represent the most fearful and common complications. We conducted a multicenter, observational study of retrospectively collected data in three high-volume referral centers, enrolling all patients undergone to thyroid surgery between January 2016 and December 2017 in Parma University Hospital, Cagliari University Hospital and Ferrara University Hospital. Materials Patients were divided into five groups, differentiated thyroid carcinoma, medullary thyroid carcinoma, non-toxic benign pathology, hyperfunctioning benign pathology and NIFTP (Non-invasive Follicular Thyroid neoplasm with Papillary-like nuclear features). A follow up at 7 and 30 days was executed, evaluating the onset of paresthesia, dysphonia and dysphagia. A 6-month follow-up was conducted in cases of early complications. Results Totally, 1252 patients were eligible for the study: 907 female and 345 male, with a female to male ratio of 2.6:1 and an average age of 53.428. Total thyroidectomy was performed in 1022 cases, lobectomy in 230. After 6 months we recorded paresthesia in 0.5%, dysphonia in 1.8% and dysphagia in 0.5%. Conclusion Our study confirms once again that a share of morbidity escapes the possibilities of prediction and control by the operator, depending on patient anamnestic, pathological or anatomical factors.
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Affiliation(s)
- Paolo Del Rio
- Unit of General Surgery, University Hospital of Parma, 14 Gramsci Road, Parma, Italy
| | - Paolo Carcoforo
- Unit of General Surgery, University Hospital of Ferrara, Cona, Italy
| | - Fabio Medas
- Unit of General Surgery, University Hospital of Cagliari, Cagliari, Italy
| | - Elena Bonati
- Unit of General Surgery, University Hospital of Parma, 14 Gramsci Road, Parma, Italy.
| | - Tommaso Loderer
- Unit of General Surgery, University Hospital of Parma, 14 Gramsci Road, Parma, Italy
| | | | - Piergiorgio Calò
- Unit of General Surgery, University Hospital of Cagliari, Cagliari, Italy
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11
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Cândido AFDS, Santos JPD, Soares MJG, Alves RF, Pernambuco L. Voice- and swallowing-related symptoms after total thyroidectomy: evidence from a Brazilian national survey. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/202123313920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to estimate the prevalence of voice- and swallowing-related symptoms in women submitted to total thyroidectomy. Methods: a population-based, observational, cross-sectional, analytical study, based on a Brazilian national survey. A total of 252 women, aged 18 to 58 years, submitted to total thyroidectomy, residing in the five geographical regions of the country participated in the study. All of them answered the version of the Thyroidectomy-Related Voice Questionnaire translated and adapted into Brazilian Portuguese, besides questions on demographic and clinical issues. A descriptive analysis of the categorical and quantitative variables was conducted. The relationship between the total TVQ score and the independent variables was analyzed with the Mann-Whitney and Kruskal-Wallis tests. The significance level used was 5%. Results: the most prevalent symptoms were, tired voice, after talking for a long time (50%), and dry mouth/thirst (43.3%). The voice-related symptoms were more prevalent than those related to swallowing. The total TVQ score was not related to age group (p=0.141), profession (p=0.213), region of residence (p=0.303), time since surgery (p=0.955), and radiotherapy/radioiodine therapy (p=0.666). Conclusion: Brazilian women submitted to total thyroidectomy have a high prevalence of voice- and swallowing-related symptoms, the former being predominant.
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Affiliation(s)
| | | | | | | | - Leandro Pernambuco
- Universidade Federal da Paraíba, Brazil; Universidade Federal da Paraíba, Brazil
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Đanić Hadžibegović A, Hergešić F, Babić E, Slipac J, Prstačić R. Thyroidectomy-related Swallowing Difficulties: Review of the Literature. Acta Clin Croat 2020; 59:38-49. [PMID: 34219883 PMCID: PMC8212616 DOI: 10.20471/acc.2020.59.s1.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This study aims to provide insight into the etiology and frequency of swallowing complications that arise after thyroidectomy and to outline the available diagnostic procedures by revising the existing literature on this topic. We conducted a bibliographic search using the electronic database MEDLINE/PubMed to identify all relevant articles and 44 studies were included in the review out of a total of 218 published articles. Dysphagia after thyroid surgery is a common postoperative complication which, in the short- or long-term, significantly affects patient life quality. There is no standard diagnostic protocol for thyroidectomy-related swallowing impairment. Among the reviewed studies, 8 questionnaires and 12 instrumental diagnostic tools were used to identify swallowing difficulties related to thyroid surgery. The Swallowing Impairment Index (SIS-6) was the most-used questionnaire. Fiberoptic endoscopy is a standard diagnostic tool performed prior and after thyroid surgery, primarily to identify changes in vocal fold mobility. Although instrumental findings usually reveal non-specific alterations of swallowing; swallowing videofluoroscopy and esophageal manometry can be the most helpful tools in further management of thyroidectomy dysphagia. In patients with thyroidectomy-related swallowing difficulties and suspected laryngopharyngeal reflux, 24-hour MII-pH metry should be performed.
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Affiliation(s)
| | - Filip Hergešić
- 1Clinical Department for ENT and Head and Neck Surgery, Zagreb University Hospital Centre, 2Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Croatia, 3School of Medicine, Zagreb University, Croatia, 4Faculty of Education and Rehabilitation Sciences University of Zagreb, Croatia
| | - Ema Babić
- 1Clinical Department for ENT and Head and Neck Surgery, Zagreb University Hospital Centre, 2Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Croatia, 3School of Medicine, Zagreb University, Croatia, 4Faculty of Education and Rehabilitation Sciences University of Zagreb, Croatia
| | - Juraj Slipac
- 1Clinical Department for ENT and Head and Neck Surgery, Zagreb University Hospital Centre, 2Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Croatia, 3School of Medicine, Zagreb University, Croatia, 4Faculty of Education and Rehabilitation Sciences University of Zagreb, Croatia
| | - Ratko Prstačić
- 1Clinical Department for ENT and Head and Neck Surgery, Zagreb University Hospital Centre, 2Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Croatia, 3School of Medicine, Zagreb University, Croatia, 4Faculty of Education and Rehabilitation Sciences University of Zagreb, Croatia
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