1
|
Albazee E, Alsubaie HM, Hintze JM, O'Riordan I, Timon C, Kinsella J, Lennon P, Fitzgerald CWR. The effectiveness of neck stretching exercises in alleviating neck pain and self-reported disability after thyroidectomy: A systematic review and meta-analysis of clinical trials. Head Neck 2024. [PMID: 39105349 DOI: 10.1002/hed.27906] [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: 11/16/2023] [Revised: 07/16/2024] [Accepted: 07/23/2024] [Indexed: 08/07/2024] Open
Abstract
Thyroidectomy can lead to significant challenges such as neck pain, disability, and limited range of motion. Therefore, our objective is to conduct a systematic review and meta-analysis of clinical trials to investigate the clinical effectiveness of neck stretching exercises in alleviating neck pain and self-reported disability immediately after thyroidectomy. We systematically searched PubMed, CENTRAL, Scopus, and Web of Science from inception until July 28th, 2023. We assessed the selected trials for the risk of bias using both the RoB-2 and ROBINS-I tools. Our specific outcomes were the severity of neck pain and self-reported disability after thyroidectomy. The results were synthesized using risk ratio (RR) and standardized mean differences (SMD) with 95% confidence intervals (CI) in a random-effects model using Stata software. Nine clinical trials, comprising five randomized and four non-randomized trials, were included, with a total of 1026 patients. Neck stretching exercises were significantly associated with improved mean pain scores both after 1 week (n = 625 patients, SMD = -2.43, 95% CI [-4.65, -0.22], p = 0.03, I2 = 98%) and 1 month (n = 545 patients, SMD = -4.11, 95% CI [-8.12, -0.11], p = 0.04, I2 = 99%). Similarly, neck stretching exercises were significantly associated with improved mean self-reported disability scores both after 1 week (n = 298 patients, SMD = -0.70, 95% CI [-1.36, -0.04], p = 0.04, I2 = 87%) and 1 month (n = 298 patients, SMD = -0.42, 95% CI [-0.65, -0.19], p = 0.0004, I2 = 0%). The pooled analysis showed heterogeneity (chi-square p < 0.01, I2 > 80%), except for the mean self-reported neck disability score after 1 month, which showed homogeneity (chi-square p > 0.01, I2 = 0%). This systematic review and meta-analysis, involving 1026 patients, revealed the potential benefits of neck stretching exercises in alleviating neck pain and self-reported disability after thyroidectomy. However, further research is required to address methodological limitations, evaluate long-term outcomes, investigate potential moderators (i.e., the duration or intensity of the exercise program), and explore patients' analgesic consumption.
Collapse
Affiliation(s)
- Ebraheem Albazee
- Kuwait Institute for Medical Specializations (KIMS), Kuwait City, Kuwait
| | - Hemail M Alsubaie
- Department of Otolaryngology - Head and Neck Surgery, St. James's Hospital, Dublin, Ireland
- Department of Otorhinolaryngology - Head and Neck Surgery and Communication Sciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Justin M Hintze
- Department of Otolaryngology - Head and Neck Surgery, St. James's Hospital, Dublin, Ireland
| | - Isobel O'Riordan
- Department of Otolaryngology - Head and Neck Surgery, St. James's Hospital, Dublin, Ireland
| | - Conrad Timon
- Department of Otolaryngology - Head and Neck Surgery, St. James's Hospital, Dublin, Ireland
- Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - John Kinsella
- Department of Otolaryngology - Head and Neck Surgery, St. James's Hospital, Dublin, Ireland
| | - Paul Lennon
- Department of Otolaryngology - Head and Neck Surgery, St. James's Hospital, Dublin, Ireland
- Department of Otolaryngology - Head and Neck Surgery, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Conall W R Fitzgerald
- Department of Otolaryngology - Head and Neck Surgery, St. James's Hospital, Dublin, Ireland
- Trinity St. James's Cancer Institute, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
2
|
Horyacheva A, Boyce K, Badesha M, Kerr C, Najeeb H, Namasivayam-MacDonald A. Identifying Non-Traditional Approaches to Swallowing Rehabilitation: A Scoping Review. Dysphagia 2024; 39:321-347. [PMID: 37853297 DOI: 10.1007/s00455-023-10622-w] [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: 06/27/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
In recent years, dysphagia care has shifted toward a more patient-centered approach. This means that dysphagia clinicians are considering more factors in the treatment process including the goals of care, quality of life, and cultural values. The purpose of this scoping review was to examine relevant research and identify dysphagia interventions outside of those traditionally used by dysphagia clinicians that may improve swallowing function. A review of relevant studies was conducted using search terms related to swallowing and treatment. The search yielded 8439 unique studies. Of the 283 articles that underwent a full-text review, 37 articles were included in the final review. These articles highlighted three potential areas of non-traditional dysphagia intervention that may serve to provide holistic care, while also aiming to improve swallowing mechanisms: acupuncture and Eastern medicine interventions, vocal exercises, and physical function exercises. The results suggest that dysphagia clinicians should work collaboratively with other allied health professionals and consider non-traditional approaches to dysphagia care. Through the identification of potentially effective but non-traditional or non-Eurocentric interventions for dysphagia care, clinicians may promote a culturally relevant, patient-centered approach, in turn increasing patient acceptance of treatment plans and compliance. Future research should explore the efficacy and feasibility of these interventions in dysphagia rehabilitation, as well as their effectiveness compared to more traditional approaches.
Collapse
Affiliation(s)
- Angela Horyacheva
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada
| | - Keara Boyce
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada
- Hamilton Health Sciences, Hamilton, ON, Canada
| | - Maneetpal Badesha
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada
| | | | - Hiba Najeeb
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada
- St. Mary's General Hospital, Kitchener, ON, Canada
| | - Ashwini Namasivayam-MacDonald
- School of Rehabilitation Science, McMaster University, 1280 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada.
| |
Collapse
|
3
|
Xu T, Qin X, Zhang Y, Li P, Ran Y, Fan Y, Zheng X, Wei T. A prospective study comparing the gasless endoscopic thyroidectomy trans-axillary approach to conventional open thyroidectomy: health and quality of life outcomes. Surg Endosc 2024; 38:1995-2009. [PMID: 38396084 DOI: 10.1007/s00464-024-10689-y] [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: 10/28/2023] [Accepted: 12/30/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND The relationship between different surgical treatments and quality of life remains uncertain for differentiated thyroid carcinoma (DTC). The aim of this study is to compare the gasless endoscopic thyroidectomy trans-axillary approach (ET) and traditional open thyroidectomy (OT) through a prospective cohort study focusing on the rate of the efficacy, and quality of life (QoL). METHODS This prospective observational longitudinal cohort study enrolled 134 female patients diagnosed with DTC from December 01/2021 to December 31/2022. Multiple scales were applicated to evaluate the differences in quality of life, effectiveness, safety, etc. between the two groups during preoperative and postoperative follow-up periods, including the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, version 3.0 (QOL-C30), Symptom Checklist (SCL-90), Scar Cosmesis Assessment and Rating (SCAR-Q), voice impairment score (VIS), swallowing impairment score (SIS), and neck impairment score (NIS). RESULTS Among them, 68 accepted ET and 66 patients underwent OT. To enhance comparability between the two groups, the patients enrolled in this study are female. Compared with the OT group, the ET group performed significantly better postoperative physical quality of life, including sound (p = 0.036), swallowing (p < 0.001), and neck function (p = 0.010). The ET group was also associated with significantly better cosmetic satisfaction (p < 0.001), and relatively faster recovery in psychological and emotional situation. CONCLUSIONS Gasless endoscopic thyroidectomy through an axillary approach leads to good cosmetic and psychological effects, improves postoperative QoL, and could be recommended for rapid postoperative recovery and involvement in daily and social activities.
Collapse
Affiliation(s)
- Tianfeng Xu
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiangquan Qin
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Department of Breast and Thyroid Surgery, Southwest Hospital, The First Affiliated Hospital of the Army Military Medical University, Chongqing, 400038, China
| | - Yujie Zhang
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Pengyu Li
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yanhao Ran
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yuanyuan Fan
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xun Zheng
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Tao Wei
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
4
|
Poddighe D, Ferriero G, Corna S, Bravini E, Sartorio F, Vercelli S. Effects of soft tissue mobilisation on subacute adherent linear scars: a single-group intervention study. J Wound Care 2024; 33:43-50. [PMID: 38197283 DOI: 10.12968/jowc.2024.33.1.43] [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: 01/11/2024]
Abstract
OBJECTIVE Scar adherence due to a pathological healing process can cause physical and psychological disturbance. Soft tissue mobilisation (STM) techniques are widely used to treat and prevent scar adherence, but little is known on their effects. We aimed to analyse the effect of STM in patients with subacute post-surgical scar adhesions affecting the extremities. METHOD A single-group quasi-experimental study was conducted on consecutive patients undergoing post-surgery limb rehabilitation. Patients with a baseline Adhesion Severity (AS) index of <0.5 at the worst scar point, as measured by the Adheremeter, were eligible. All patients who completed a minimum of five manual treatment sessions were included. The primary outcome was the AS index and the secondary outcome was the Italian version of the Patient and Observer Scar Assessment Scales (POSAS-I). RESULTS A cohort of 19 patients underwent an average of eight STM sessions over a period of one month. The AS index value increased from a median of 0.12 at baseline (interquartile range (IQR): 0.05-0.25) to 0.41 post-treatment (IQR: 0.26-0.63; median change: 0.24; IQR: 0.16-0.40; p<0.001). A large effect size was observed for both AS and Observer Scar Assessment Scale (OSAS-I) (Cohen r=0.6), with a large probability of superiority (PS) (87% and 86%, respectively). A moderate effect was observed for the Patient Scar Assessment Scale (PSAS-I) (Cohen=0.4; PS=71%). Pre-post treatment changes exceeded the minimal detectable changes for the AS and OSAS-I in 68% of subjects, and for PSAS-I in 21% of subjects. CONCLUSION STM manual techniques may produce a large effect on the mobility of adherent subacute post-surgical scars.
Collapse
Affiliation(s)
- Diego Poddighe
- KU Leuven, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, B-3000 Leuven, Belgium
| | - Giorgio Ferriero
- Physical and Rehabilitation Medicine Unit, Istituti Clinici Scientifici Maugeri, Institute of Tradate, IRCCS, Tradate (VA), Italy
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Stefano Corna
- Physical and Rehabilitation Medicine Unit, Istituti Clinici Scientifici Maugeri, Institute of Veruno, IRCCS, Gattico-Veruno (NO), Italy
| | | | - Francesco Sartorio
- Physical and Rehabilitation Medicine Unit, Istituti Clinici Scientifici Maugeri, Institute of Veruno, IRCCS, Gattico-Veruno (NO), Italy
- Department of Scientific Research, Campus LUdeS Lugano (CH), Off-Campus Semmelweis University of Budapest, Hungary
| | - Stefano Vercelli
- Physical and Rehabilitation Medicine Unit, Istituti Clinici Scientifici Maugeri, Institute of Veruno, IRCCS, Gattico-Veruno (NO), Italy
- Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| |
Collapse
|
5
|
Chen Z, Guo Y, Huo J, Hu X, Chen C, Gao D, Yang L, Wang C, Qu R. Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): Influences on the Voice Changes and Swallowing Function Disorders. Surg Laparosc Endosc Percutan Tech 2023; 33:587-591. [PMID: 37852216 DOI: 10.1097/sle.0000000000001238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 09/07/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the influence of transoral endoscopic thyroidectomy vestibular approach (TOETVA) on voice changes and swallowing function disorders. MATERIALS AND METHODS We retrospectively reviewed 215 patients who underwent thyroid surgery with TOETVA (105 cases, endoscopic group) and open approach (110 cases, open group). Major outcomes, the changes in voice and swallowing function in the 2 groups of patients before and after surgery were analyzed by using both subjective and objective evaluation indexes. Subjective evaluation indexes included the Voice Handicap Index, voice GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) classification, and swallowing impairment score; the objective indicators included the fundamental frequency (F0), fundamental frequency perturbation (jitter), amplitude perturbation (shimmer), and maximum phonation time. RESULTS In terms of subjective evaluation indexes, there were no significant differences (all P> 0.05) between the groups regarding Voice Handicap Index (1 and 3 mo after surgery) and GRBAS (1 and 3 mo after surgery). The incidence rates of swallowing disorder in the endoscopic group were higher than that in the open group according to the outcomes of swallowing impairment score at 1 and 3 months after surgery (both P< 0.05). In addition, no significant changes in terms of jitter, shimmer, and maximum phonation time in both groups of patients at 1 and 3 months after surgery compared with their preoperative values (all P> 0.05). CONCLUSIONS Voice and swallowing disorders may occur in some patients, either TOETVA or open thyroid surgery, which in most cases will recover within 3 months after surgery. The time to swallowing function recovery is relatively prolonged in patients following TOETVA, which may be probably associated with neck adhesion and fixation after the operation.
Collapse
Affiliation(s)
- Zongyi Chen
- Department of Thyroid Surgery, First People's Hospital of Zunyi/Third Affiliated Hospital of Zunyi Medical University, Zunyi
| | - Youming Guo
- Department of Thyroid Surgery, First People's Hospital of Zunyi/Third Affiliated Hospital of Zunyi Medical University, Zunyi
| | - Jinlong Huo
- Department of Thyroid Surgery, First People's Hospital of Zunyi/Third Affiliated Hospital of Zunyi Medical University, Zunyi
| | - Xiaochi Hu
- Department of Thyroid Surgery, First People's Hospital of Zunyi/Third Affiliated Hospital of Zunyi Medical University, Zunyi
| | - Chen Chen
- Department of Thyroid Surgery, First People's Hospital of Zunyi/Third Affiliated Hospital of Zunyi Medical University, Zunyi
| | - Dan Gao
- Department of Thyroid Surgery, First People's Hospital of Zunyi/Third Affiliated Hospital of Zunyi Medical University, Zunyi
| | - Li Yang
- Department of Thyroid Surgery, First People's Hospital of Zunyi/Third Affiliated Hospital of Zunyi Medical University, Zunyi
| | - Cunchuan Wang
- Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Rui Qu
- Department of Thyroid Surgery, First People's Hospital of Zunyi/Third Affiliated Hospital of Zunyi Medical University, Zunyi
| |
Collapse
|
6
|
Huo J, Xu Y, Yu J, Guo Y, Hu X, Ou D, Qu R, Zhao L. Endoscopic thyroidectomy via areola approach for stage T1 papillary thyroid carcinoma: feasibility, safety, and oncologic outcomes. Front Endocrinol (Lausanne) 2023; 14:1212490. [PMID: 38075056 PMCID: PMC10702212 DOI: 10.3389/fendo.2023.1212490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
Purpose To evaluate the feasibility, safety, and oncologic outcomes associated with endoscopic thyroidectomy via the areolar approach (ETAA), compared with conventional open thyroidectomy (COT) for the treatment of stage T1 papillary thyroid carcinoma (PTC). Methods Between January 2021 and June 2022, a total of 1204 patients diagnosed with PTC underwent screening, out of which 138 patients were selected for inclusion in the study population after propensity score matching (92 patients in the ETAA group and 46 patients in the COT group). The study included the collection and analysis of clinicopathologic characteristics, intraoperative outcomes, postoperative outcomes, complications, and follow-up data using R software. Results The operative time for the ETAA group was longer than that for the COT group (160.42 ± 32.21 min vs. 121.93 ± 29.78 min, p < 0.0001). However, there were no significant differences between the two groups in terms of intraoperative blood loss, the extent of surgical resection, the number of dissected lymph nodes, the number of metastatic lymph nodes, and the rate of parathyroid autotransplantation. Postoperative drainage and C-reactive protein levels were higher in the ETAA group than in the COT group, but there were no significant differences in 24-hour visual analogue scale scores, white blood cell counts, drainage duration, or postoperative hospital stay. Complication rates were similar between the two groups, and no permanent recurrent laryngeal nerve palsy or hypoparathyroidism was observed. Patients who underwent ETAA reported greater cosmetic satisfaction and quality of life than those who underwent COT. During the follow-up phase, only one patient in the COT group developed lateral cervical lymph node involvement requiring reoperation. Conclusion ETAA is a safe and feasible surgical method for patients with stage T1 PTC, providing results similar to COT in terms of oncologic completeness, while avoiding neck scars, with excellent cosmetic effects. Clinical trial registration Chinese Clinical Trial Registry center, identifier ChiCTR2300077109.
Collapse
Affiliation(s)
- Jinlong Huo
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Department of Breast and Thyroid Surgery, The Third Affiliated Hospital of Zunyi Medical University (The First People’s Hospital of Zunyi), Zunyi, Guizhou, China
| | - Yaxuan Xu
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Jie Yu
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Youming Guo
- Department of Breast and Thyroid Surgery, The Third Affiliated Hospital of Zunyi Medical University (The First People’s Hospital of Zunyi), Zunyi, Guizhou, China
| | - Xiaochi Hu
- Department of Breast and Thyroid Surgery, The Third Affiliated Hospital of Zunyi Medical University (The First People’s Hospital of Zunyi), Zunyi, Guizhou, China
| | - Dong Ou
- Department of Oncology, The Third Affiliated Hospital of Zunyi Medical University (The First People’s Hospital of Zunyi), Zunyi, Guizhou, China
| | - Rui Qu
- Department of Breast and Thyroid Surgery, The Third Affiliated Hospital of Zunyi Medical University (The First People’s Hospital of Zunyi), Zunyi, Guizhou, China
| | - Lijin Zhao
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| |
Collapse
|
7
|
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.
Collapse
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;
| |
Collapse
|
8
|
Huo J, Guo Y, Chen C, Zhao L, Wen K. Effects of Different Levels of Surgical Separation on Neck Bulge and Swallowing Disorders during Endoscopic Thyroidectomy. Surg Laparosc Endosc Percutan Tech 2023; 33:365-369. [PMID: 37311030 DOI: 10.1097/sle.0000000000001183] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/08/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Our study aims to compare the effects of different levels of access on postoperative neck bulge and swallowing disorder and provide a better level for endoscopic thyroidectomy. MATERIALS AND METHODS The patients were selected retrospectively between March 2021 to September 2021 by the Department of Thyroid Surgery, Third Affiliated Hospital of Zunyi Medical University. They were divided into two groups according to the level of the free flap during surgery: group A (the superficial cervical fascial level) and group B (the superficial deep cervical fascial level). Age, sex, body mass index, diameter of the primary lesion, postoperative neck bulge, and swallowing disorders and other complications were compared between the two groups. RESULTS A total of 40 patients who underwent endoscopic unilateral lobectomy plus central region lymph node dissection were enrolled in our study. Twenty in group A and 20 in group B. The age, gender, body mass index, diameter, and the proportion of benign and malignant primary lesions were not significantly different between the two groups ( P >0.05), and there was also no difference in thyroid function between the two groups ( P >0.05). No significant differences were observed in terms of bleeding and operation time during the operation ( P >0.05). There were also no statistical differences in terms of recurrent laryngeal nerve injury or hypoparathyroidism ( P >0.05). However, patients in group B were superior to those in group A in the occurrence of neck bulge and swallowing disorders ( P <0.05). These symptoms were most evident one month after surgery. Six months after the operation, only 4 patients in group B still complained of neck "swelling" and uncomfortable straining which did not resolve until 1 year after the operation. No statistical significance between long-term results and complication rates could be observed in either group. CONCLUSION In endoscopic thyroidectomy, the superficial cervical fascial level may be a better option for reducing postoperative neck bulge and swallowing disorders, which needs further validation by conducting a large sample study.
Collapse
Affiliation(s)
- Jinlong Huo
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University
| | - Youming Guo
- Department of Thyroid and Breast surgery, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi), Zunyi, Guizhou, China
| | - Chen Chen
- Department of Thyroid and Breast surgery, The Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi), Zunyi, Guizhou, China
| | - Lijin Zhao
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University
| | - Kunming Wen
- Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University
| |
Collapse
|
9
|
Ebersole BM, McMillan H, Hutcheson K. Evaluation and Management of Speech and Swallowing Issues in RFS. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2023. [DOI: 10.1007/s40141-023-00388-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023]
|
10
|
Is massage an effective intervention in the management of post-operative scarring? A scoping review. J Hand Ther 2022; 35:186-199. [PMID: 35227556 DOI: 10.1016/j.jht.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/21/2021] [Accepted: 01/21/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Scar massage is a widely used treatment modality in hand therapy. This intervention is thoroughly discussed in the literature relating to burns rehabilitation, however, the evidence for its use in treating linear scars following surgery is limited. PURPOSE OF STUDY To collate the empirical literature on scar massage for the treatment of postsurgical cutaneous scars. STUDY DESIGN Scoping review. METHODS Medline, EMBASE, CINAHL, AMED, Scopus, ProQuest Dissertations & Theses Global, and the Joanna Briggs Institute were searched from inception to December 2020. Two researchers used a data extraction tool to record key demographic, intervention and outcome data, and to apply the Oxford Levels of Evidence for each study. RESULTS Twenty-five studies met the inclusion criteria, reporting on a combined sample of 1515 participants. Only two papers addressed hand or wrist scars (92 participants). While all studies reported favorable outcomes for scar massage, there were 45 different outcome measures used and a propensity towards non-standardized assessment. Intervention protocols varied from a single session to three treatments daily for 6 months. The results from 13 studies were confounded by the implementation of additional rehabilitation interventions. CONCLUSIONS The overall findings suggest that while there may be benefits to scar massage in reducing pain, increasing movement and improving scar characteristics; there is a lack of consistent research methods, intervention protocols and outcome measures. This scoping review highlights the heterogenous nature of research into scar massage following surgery and supports the need for further research to substantiate its use in the clinical setting.
Collapse
|
11
|
The Impact of Post-Thyroidectomy Neck Stretching Exercises on Neck Discomfort, Pressure Symptoms, Voice and Quality of Life: A Randomized Controlled Trial. World J Surg 2022; 46:2212-2222. [PMID: 35637354 PMCID: PMC9150879 DOI: 10.1007/s00268-022-06610-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 11/01/2022]
Abstract
Background Methods Results Conclusions
Collapse
|
12
|
Modabber A, Winnand P, Goloborodko E, Möhlhenrich SC, Kniha K, Tolba R, Jockenhoevel S, Hermanns-Sachweh B, Hölzle F, Heitzer M. Biodegradation and Immunological Parameters of Polyurethane-based Tissue Adhesive in Arterial Microvascular Anastomoses - a Long-term in Vivo Study. Macromol Biosci 2022; 22:e2100451. [PMID: 35080346 DOI: 10.1002/mabi.202100451] [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: 11/08/2021] [Revised: 01/16/2022] [Indexed: 11/07/2022]
Abstract
In microsurgical anastomosis, non-synthetic fibrin-based adhesives have predominantly shown superior properties to synthetic cyanoacrylates, but they have hardly any clinical application. This study aimed to investigate the local and systemic effects of synthetically produced biodegradable adhesive VIVO when used in microsurgical anastomosis. VIVO was used in two different anastomosis procedures in the common carotid artery in a rat model: VIVO in addition to a temporary catheter (VIVO TC) and VIVO with a custom-shaped memory nitinol stent (VIVO SM). Conventionally sutured anastomoses served as controls (C). Tissue response was assessed by in vivo fluorescence imaging and histological examination. The systemic effects of biodegradation were measured using hematologic parameters and serum levels of transaminase activity and lactate dehydrogenase. Finally, the degree of local adhesion of the different anastomotic procedures was evaluated. Fluorescence imaging showed reduced inflammatory blood flow in the VIVO TC group. Histological analysis of the anastomosed vessels also revealed significantly more inflammation in C than in the two adhesive groups. The severity of VIVO adhesions proved acceptable, and no histotoxic effects of VIVO were detected. The data demonstrated that the synthetic tissue adhesive VIVO is a reliable and- compared to sutures-tissue-friendly adhesive for microsurgical anastomoses. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, Aachen, 52074, Germany.,Head & Chairman Univ. Prof. Dr. med. Dr. med. dent. Frank Hölzle
| | - Philipp Winnand
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, Aachen, 52074, Germany.,Head & Chairman Univ. Prof. Dr. med. Dr. med. dent. Frank Hölzle
| | - Evgeny Goloborodko
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, Aachen, 52074, Germany.,Head & Chairman Univ. Prof. Dr. med. Dr. med. dent. Frank Hölzle
| | - Stephan Christian Möhlhenrich
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, Aachen, 52074, Germany.,Head & Chairman Univ. Prof. Dr. med. Dr. med. dent. Frank Hölzle.,Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, Witten, 58455, Germany.,Head & Chairman Univ.-Prof. Dr. med. dent. Golamreza Danesh
| | - Kristian Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, Aachen, 52074, Germany.,Head & Chairman Univ. Prof. Dr. med. Dr. med. dent. Frank Hölzle
| | - René Tolba
- Institute of Laboratory Animal Science and Experimental Surgery of RWTH-Aachen, Pauwelsstraße 30, Aachen, 52074, Germany.,Head & Chairman Univ.-Prof. Dr. med. René H. Tolba
| | - Stefan Jockenhoevel
- Department of Biohybrid and Medical Textiles (BioTex), AME-Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen, 52074, Germany
| | - Benita Hermanns-Sachweh
- Implant Pathology ZBMT, Campus Melaten, Pauwelsstraße 17, Aachen, 52074.,Prof. Dr. med. Benita Hermanns-Sachweh
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, Aachen, 52074, Germany.,Head & Chairman Univ. Prof. Dr. med. Dr. med. dent. Frank Hölzle
| | - Marius Heitzer
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, Aachen, 52074, Germany.,Head & Chairman Univ. Prof. Dr. med. Dr. med. dent. Frank Hölzle
| |
Collapse
|
13
|
Ahn JH, Yoon SG, Yi JW, Kim SJ, Lee KE. Anti-adhesive effect and safety of a thermosensitive adhesion barrier (Mediclore) for thyroid surgery: a double-blinded randomized controlled trial. Ann Surg Treat Res 2022; 102:313-322. [PMID: 35800997 PMCID: PMC9204021 DOI: 10.4174/astr.2022.102.6.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/12/2022] [Accepted: 05/19/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose Methods Results Conclusion
Collapse
Affiliation(s)
- Jong-hyuk Ahn
- Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
| | - Sang Gab Yoon
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Young Do Hospital, Busan, Korea
| | - Jin Wook Yi
- Department of Surgery, Inha University College of Medicine, Incheon, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Inha University Hospital, Incheon, Korea
| | - Su-jin Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu Eun Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Korea
| |
Collapse
|
14
|
Yu HW, Lee D, Lee K, Kim SJ, Chai YJ, Kim HC, Choi JY, Lee KE. Effect of an anti-adhesion agent on vision-based assessment of cervical adhesions after thyroid surgery: randomized, placebo-controlled trial. Sci Rep 2021; 11:19935. [PMID: 34620907 PMCID: PMC8497539 DOI: 10.1038/s41598-021-97919-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 09/01/2021] [Indexed: 11/23/2022] Open
Abstract
Many patients experience cervical adhesions after thyroid surgery. To date, however, no studies have objectively measured the effects of anti-adhesion agents on cervical adhesion symptoms. This study evaluated the effects of an anti-adhesion agent on cervical adhesions after thyroid surgery, as determined using a system that measures the extent of marker movement objectively. One hundred patients were randomized in a 1:1 ratio to undergo thyroid surgery with or without the anti-adhesion agent Collabarrier. Using specially manufactured recording equipment, the position of the marker on neck skin was measured before surgery, and 2 weeks, 3 months, and 9 months after surgery. Relative change in marker distance, calculated by subtracting the marker position before surgery from the marker positions 2 weeks, 3 months, and 9 months after surgery, differed significantly in the groups of patients who underwent thyroid surgery with and without the anti-adhesion agent (P < 0.05). A novel measuring system can objectively evaluate the effectiveness of a thyroid anti-adhesion agent. The anti-adhesion agent used significantly reduced adhesions compared with the control group. The trial is registered at www.cris.nih.go.kr (KCT0005745; date of registration, 08/01/2021).
Collapse
Affiliation(s)
- Hyeong Won Yu
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam-si, Korea
| | - Dongheon Lee
- Department of Biomedical Engineering, Chungnam National University College of Medicine and Hospital, Daejeon, Korea
| | - Keunchul Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam-si, Korea
| | - Su-Jin Kim
- Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Young Jun Chai
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hee Chan Kim
- Department of Biomedical Engineering and Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - June Young Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam-si, Korea.
| | - Kyu Eun Lee
- Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea
| |
Collapse
|
15
|
Kim H, Woo SH. Endoscopically-Assisted Scar-Free Midline Neck Mass Excision. Clin Exp Otorhinolaryngol 2021; 14:251-258. [PMID: 34407369 PMCID: PMC8373841 DOI: 10.21053/ceo.2020.02446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 06/25/2021] [Indexed: 11/22/2022] Open
Abstract
Traditional open surgery is indicated for the treatment of selected tumor subsites in the head and neck. However, it can cause major cosmetic problems and functional pathologies. The endoscopically-assisted transoral approach is increasingly preferred in some surgical fields due to its superior cosmetic and functional outcomes. Nonetheless, endoscopically-assisted transoral approach is not yet standard in the head and neck due to their anatomical complexity. The transoral surgical approach has been used for head and neck masses since the 1960s, and its application continues to evolve with changing disease conditions and recent innovations in surgical instruments. The potential for wide application of transoral surgery continues to be investigated, with a focus on minimizing occurrence of the complications. This review presents details of the surgical procedure and postoperative clinical outcomes, as well as endoscopically-assisted scar-free techniques for the resection of midline neck masses.
Collapse
Affiliation(s)
- Hyoyeon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
| | - Seung Hoon Woo
- Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
| |
Collapse
|
16
|
Shen S, Hu X, Qu R, Guo Y, Luo L, Chen X. Comparing quality of life between patients undergoing trans-areola endoscopic thyroid surgery and trans-oral endoscopic thyroid surgery. BMC Surg 2021; 21:277. [PMID: 34082738 PMCID: PMC8173922 DOI: 10.1186/s12893-021-01267-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/21/2021] [Indexed: 12/17/2022] Open
Abstract
Background Compared with conventional open surgery, endoscopic thyroidectomy via the oral vestibular approach (ETVOA) and endoscopic thyroidectomy via the areola approach (ETAA) avoided scarring of the skin, which may help patients achieve a better quality of life (QOL). However, the benefit of the QOL from this technique has not been adequately investigated, therefore this study compared the QOL outcomes between ETVOA and ETAA. Methods 131 patients were enrolled in this study. ETAA surgery and ETVOA surgery were performed in 74 patients and 57 patients, respectively. These patients were followed up at 2 weeks, 4 weeks, and 8 weeks, and their QOL was evaluated using a thyroid surgery-specific questionnaire and a short-form health survey (SF-36). Results There were no differences in clinical characteristics such as gender, age, body mass index (BMI), and tumor size between the two groups. The volume of intraoperative blood loss, cost of hospitalization, and complications between the two procedures showed no differences. Compared with ETAA, ETVOA has a longer operation time, no drainage, and shorter hospital stay. In the QOL questionnaire, several parameters in ETVOA were better. The satisfaction scores of patients undergoing ETVOA were higher. In addition, the cosmetic satisfaction in patients who received ETOVA was significantly better than that of patients who underwent ETAA. The degree of neck movement disorder in patients with ETVOA was milder. Patients who received ETVOA had higher score on the SF-36. Conclusions The trans-oral endoscopic approach can acquire better cosmetic results and achieved high-level QOL.
Collapse
Affiliation(s)
- Shuang Shen
- Department of Breast & Thyroid Surgery, Third Affiliated Hospital of Zunyi Medical University/First People's Hospital of Zunyi, Zunyi, 563000, China
| | - Xiaochi Hu
- Department of Breast & Thyroid Surgery, Third Affiliated Hospital of Zunyi Medical University/First People's Hospital of Zunyi, Zunyi, 563000, China
| | - Rui Qu
- Department of Breast & Thyroid Surgery, Third Affiliated Hospital of Zunyi Medical University/First People's Hospital of Zunyi, Zunyi, 563000, China
| | - Youming Guo
- Department of Breast & Thyroid Surgery, Third Affiliated Hospital of Zunyi Medical University/First People's Hospital of Zunyi, Zunyi, 563000, China
| | - Libo Luo
- Department of Breast & Thyroid Surgery, Third Affiliated Hospital of Zunyi Medical University/First People's Hospital of Zunyi, Zunyi, 563000, China
| | - Xin Chen
- Department of Breast & Thyroid Surgery, Third Affiliated Hospital of Zunyi Medical University/First People's Hospital of Zunyi, Zunyi, 563000, China.
| |
Collapse
|
17
|
Ryu CH, Lee SJ, Cho JG, Choi IJ, Choi YS, Hong YT, Jung SY, Kim JW, Lee DY, Lee DK, Lee SJ, Lee YC, Lee YS, Nam IC, Park KN, Park YM, Sung ES, Son HY, Seo IH, Lee BJ, Lim JY. Care and Management of Voice Change for Thyroid Surgery: Korean Society of Laryngology, Phoniatrics and Logopedics Clinical Practice Guideline. Clin Exp Otorhinolaryngol 2021; 15:24-48. [PMID: 34098629 PMCID: PMC8901944 DOI: 10.21053/ceo.2021.00633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/31/2021] [Indexed: 11/22/2022] Open
Abstract
Voice change is a common complaint after thyroid surgery and has significant impacts on quality of life. The Korean Society of Laryngology, Phoniatrics, and Logopedics set up a task force team to establish guideline recommendations on education, care, and management related to thyroid surgery. The guideline recommendations include preoperative voice education, management of anticipated voice change during surgery, and comprehensive voice care after thyroid surgery, including in-depth information and up-to-date knowledge based on validated literature. The committee constructed 14 key questions (KQ) in three categories: preoperative (KQ1-2), 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. Detailed evidence profiles are presented for each recommendation. The level of evidence for each recommendation is classified into high, moderate, and low-quality. The recommendation's strengths are adjusted to consider the level of evidence resulting in the recommendation and are divided into strong and weak. 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.
Collapse
Affiliation(s)
| | - Chang Hwan Ryu
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Seung Jin Lee
- Division of Speech Pathology and Audiology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon, Korea
| | - Jae-Gu Cho
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Ik Joon Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological Medical Sciences, Seoul, Korea
| | - Yoon Seok Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Yeungnam University, College of Medicine, Daegu, Korea
| | - Yong Tae Hong
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, Jeonbuk National University Hospital, Jeonju, Korea
| | - Soo Yeon Jung
- Department of Otorhinolaryngology Head and Neck Surgery, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Ji Won Kim
- Department of Otorhinolaryngology Head and Neck Surgery, Inha University, College of Medicine, Incheon, Korea
| | - Doh Young Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University, College of Medicine, Seoul, Korea
| | - Dong Kun Lee
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, Dong-A University, Busan, Korea
| | - Sang Joon Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Dankook University, College of Medicine, Cheonan, Korea
| | - Young Chan Lee
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Yong Sang Lee
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Inn Chul Nam
- Department of Otorhinolaryngology Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Ki Nam Park
- Department of Otorhinolaryngology Head and Neck Surgery, Soonchunhyang University, College of Medicine, Bucheon, Korea
| | - Young Min Park
- Department of Otorhinolaryngology Head and Neck Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Eui-Suk Sung
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Hee Young Son
- Department of Otorhinolaryngology Head and Neck Surgery, Dongnam Institute Of Radiological & Medical Sciences, Busan, Korea
| | - In Hyo Seo
- Voice & Speech Clinic, College of Medicine, Dankook University, Cheonan, Korea
| | - Byung-Joo Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology Head and Neck Surgery, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
18
|
Kim SY, Kim GJ, Lee DH, Bae JS, Lee SH, Kim JS, Hwang YS, Shim MR, Park YH, Sun DI. Analysis of voice changes after thyroidectomy using the thyroidectomy-related voice and symptom questionnaire. Auris Nasus Larynx 2021; 48:963-972. [PMID: 33896674 DOI: 10.1016/j.anl.2021.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/01/2021] [Accepted: 03/25/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE After thyroidectomy, many patients suffer from voice problems and vague neck discomfort. The Thyroidectomy-related Voice and Symptom Questionnaire (TVSQ) is a self-administered questionnaire used to evaluate pre- and post-operative vocal status as well as throat and neck discomfort. We investigated voice conditions in thyroidectomy patients using the TVSQ as well as correlations between TVSQ responses and objective voice parameters. Also, we examined whether any clinicopathologic or surgical factors affect phonetic change after thyroidectomy. METHODS We retrospectively reviewed the records of 242 patients who underwent total thyroidectomy to treat papillary carcinoma between January to December of 2019. Of these, we enrolled 232 who exhibited normal vocal cord mobility after surgery. TVSQ responses and acoustic voice analysis results were examined preoperatively and at 1, 3, and 6 months postoperatively. We subclassified patients into favorable and unfavorable TVSQ groups based on the increase in TVSQ score (△TVSQ ≥20) at 1 month postoperatively. We then investigated the difference of acoustic characteristics between two groups and analyzed the correlations between acoustic parameters and various clinical and surgical factors including pathologic results and lymph node status by subgroup. RESULT All acoustic voice parameters except for the noise-to-harmonics ratio were significantly worse at 1 month postoperatively and recovered over time, but the TVSQ score did not recover from the 1-month value until 6 months postoperatively. In the subgroups, among the many clinicopathologic factors examined, advanced N stage (p = 0.002) and high positive total and central-and-lateral-neck lymph node ratios were significantly associated with an increased risk of an unfavorable TVSQ (p = 0.049, 0.027, <0.01, respectively). Among the acoustic parameters, only the changes in TVSQ total score and voice score were correlated with deterioration in jitter and shimmer at 1 month postoperatively. However, the correlations was not statistically significant and had disappeared at 6 months postoperatively. CONCLUSION We figured out that TVSQ was able to capture the negative effects of lymph node status and lymph node dissection on vocal outcomes after thyroidectomy. Although there was a weak correlation between worsened perturbation value and TVSQ changes, no other acoustic analysis parameters were statistically significant correlated with the TVSQ score.
Collapse
Affiliation(s)
- Sang-Yeon Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje, University of Korea, Busan, Republic of Korea
| | - Geun-Jeon Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Hyun Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ja-Seong Bae
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - So-Hee Lee
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeong-Soo Kim
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeon-Shin Hwang
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mi-Ran Shim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Hak Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Il Sun
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| |
Collapse
|
19
|
Miyauchi A, Ito Y, Miya A. Stretching Exercise for the Prevention of Postoperative Neck Symptoms Following Thyroid Surgery. VideoEndocrinology 2021; 8:10.1089/ve.2021.0003. [PMID: 36199939 PMCID: PMC9529300 DOI: 10.1089/ve.2021.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/15/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: Thyroid surgery is a popular and effective treatment for many thyroid diseases, including thyroid cancer. However, patients who undergo thyroid surgery often experience discomfort symptoms such as stretching, pressing, or choking feelings in the neck, headache, shoulder stiffness, and difficulty in moving the neck or shoulders. These symptoms may persist for long durations. Based on our prospective randomized study published in 2005,1 we instructed patients who underwent thyroid surgery at Kuma Hospital to perform stretching exercises starting from the day after the surgery. Although we are of the opinion that this management is easy and effective, it might not be well recognized in the world. The purpose of this video is to demonstrate our method of instructing exercises to patients after thyroid surgery and to briefly describe our rehabilitation study. Materials and Methods: Patients who underwent thyroid surgery, except for those who had undergone reconstruction of the recurrent laryngeal nerve or trachea, were instructed stretching exercises starting the morning after surgery, to be performed at least thrice a day until their neck–shoulder symptoms disappeared. In our prospective randomized study, a total of 409 patients, including 234 patients with thyroid cancer, were randomly allocated into a stretching group and a control group that was not given the stretching instruction.1 Questionnaire surveys on neck symptoms were administered before the surgery and 1 week, 1 month, 6 months, and 1 year after the surgery. Results: The postoperative neck symptoms declined gradually after the surgery in both the groups over the study period. The total symptom scores were significantly lower in the stretching group than those in the control group at all the time points after the surgery (p < 0.0001).1 The difference between the total symptom score at 1 year and that before surgery decreased to 0.3 in the stretching group, suggesting nearly full recovery, whereas the difference was 1.8 in the control group, indicating persistence of the neck discomfort symptoms (p < 0.0001).1 Since we initiated the routine stretching exercise after thyroid surgery, we noticed in daily clinical practice that the proportion of patients who complained of postoperative neck symptoms had decreased and so did the extent of the symptoms. In the literature, there are several reports on neck–shoulder symptoms after thyroid surgery. However, we found only three articles, including ours, written in English on the prevention or treatment of these symptoms. Lee et al.2 reported that wound massage was effective for managing neck discomfort and voice changes after thyroid surgery. We believe that stretching might be easier for patients. Genç et al.3 tried cervical kinesiotaping after thyroid surgery and reported that it was not effective for postoperative neck–shoulder symptoms, although it reduced the use of analgesics. Conclusions: Stretching exercises, starting from the day after thyroid surgery, are simple and easy to perform and effectively prevent postoperative neck discomfort symptoms. No competing financial interests exist. Runtime of video: 10 mins 4 secs
Collapse
Affiliation(s)
| | - Yasuhiro Ito
- Department of Surgery, Kuma Hospital, Hyogo, Japan
| | - Akihiro Miya
- Department of Surgery, Kuma Hospital, Hyogo, Japan
| |
Collapse
|
20
|
Kim SY, Park JO, Bae JS, Lee SH, Hwang YS, Shim MR, Park YH, Sun DI. How Can We Predict the Recovery from Pitch Lowering After Thyroidectomy? World J Surg 2021; 44:3395-3404. [PMID: 32488661 DOI: 10.1007/s00268-020-05628-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Some of patients are suffered from pitch lowering of voice after thyroidectomy. We sought to identify factors predictive of a recovery from lowered pitch voice after thyroid surgery. METHODS We retrospectively reviewed the records of 133 patients who underwent total thyroidectomy to treat papillary carcinoma between January 2012 and February 2013. Of these, we enrolled 78 who exhibited a lower-pitched voice (SFF fall > 12 Hz) at 2 weeks post-operatively than pre-operatively and investigated pitch recovery after 3 months. We subclassified patients into recovery and non-recovery groups and compared videostroboscopic findings, acoustic voice data, and thyroidectomy-related voice questionnaire scores pre-operatively and 2, 8, and 12 weeks post-operatively. RESULTS Vocal cord asymmetry on videostroboscopic examination at 2 weeks post-operatively (odds ratio 19.056, p = 0.001*) was more frequent in the non-recovery group. In acoustic analysis, mean pre-operative SFF was higher in the non-recovery group than the recovery group (190.9 ± 27.5 and 180.9 ± 24.6 Hz, respectively; p = 0.030*). Also, a reduction in the SFF of > 19.6 Hz, at 2 weeks post-operatively versus pre-operatively, predicted non-recovery of pitch-lowering in patients with reduced SFF within post-operative 3 months, with 72.0% sensitivity and 71.2% specificity. After 6 months of follow-up, no patient who exhibited an SFF fall > 19.6 Hz recovered to within 10 Hz of the pre-operative value. CONCLUSION A reduction in the speaking fundamental frequency (SFF) > 19.6 Hz at 2 weeks post-operatively predicted persisting lowering of voice pitch after thyroidectomy among those with lower-pitched voices after surgery. Pre-operative high SFF and post-operative stroboscopic findings including vocal cord asymmetry at 2 weeks post-operatively also predicted persisting lowering of voice pitch for 3 months.
Collapse
Affiliation(s)
- Sang-Yeon Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Jun-Ook Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ja-Seong Bae
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - So-Hee Lee
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeon-Shin Hwang
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mi-Ran Shim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Hak Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Il Sun
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| |
Collapse
|
21
|
Xue S, Wang Q, Chen G, Wang P, Zhang L. Supraclavicular Approach of Lobectomy Improves Quality of Life for Patients With Unilateral Papillary Thyroid Microcarcinoma: A Prospective Cohort Study. Front Endocrinol (Lausanne) 2021; 12:766444. [PMID: 35058877 PMCID: PMC8764192 DOI: 10.3389/fendo.2021.766444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/29/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Postoperative neck symptoms, including pain, swelling, uncomfortable feelings during swallowing, and incision adhesion formation, are common in patients after lobectomy through the traditional middle neck approach. A new unilateral supraclavicular approach is proposed to protect the anterior cervical region and reduce related complications. The aim of this study is to investigate the efficacy, safety, and advantages of the supraclavicular approach in lobectomy for unilateral papillary thyroid microcarcinoma (PTMC). METHODS Two hundred sixty-three patients were recruited into either a conventional middle group (CM) or a new supraclavicular (NS) group. Clinicopathological features, surgically related variables, and postoperative symptoms were recorded. Quality of life (QOL) of all patients was assessed by the 12-item short-form health survey (SF-12) and thyroid cancer-specific QOL (THYCA-QoL) questionnaire in 3 and 12 months. RESULTS There were no statistically significant differences in clinicopathological features (including sex, age, multifocality, extrathyroidal extension, histological variants, largest tumor diameter, Hashimoto's thyroiditis, metastasized central lymph node, removed central lymph node, surgeon, BRAF mutation, and follow-up duration), hospitalization (including hospital cost, surgery time, and blood loss during surgery), and complications between the two groups. Patients who underwent lobectomy through the NS approach had significantly better SF-12 physical, mental, and THYCA-QoL than the CM group patients in both 3 and 12 months (all p < 0.001). Moreover, the NS group had a shorter hospitalization time. CONCLUSION In conclusion, the NS approach for lobectomy is a safe and effective method for reducing postoperative symptoms and increasing QOL in patients with unilateral PTMC in both 3 and 12 months' follow-up.
Collapse
Affiliation(s)
- Shuai Xue
- Department of Thyroid Surgery, The 1st Hospital of Jilin University, Changchun, China
| | - Qiuli Wang
- Department of Thyroid Surgery, The 1st Hospital of Jilin University, Changchun, China
| | - Guang Chen
- Department of Thyroid Surgery, The 1st Hospital of Jilin University, Changchun, China
- *Correspondence: Li Zhang, ; Guang Chen,
| | - Peisong Wang
- Department of Thyroid Surgery, The 1st Hospital of Jilin University, Changchun, China
| | - Li Zhang
- Department of Nephrology, The 1st Hospital of Jilin University, Changchun, China
- *Correspondence: Li Zhang, ; Guang Chen,
| |
Collapse
|
22
|
Kim SY, Kim GJ, Lee DH, Bae JS, Lee SH, Kim JS, Hwang YS, Shim MR, Park YH, Sun DI. Voice change after thyroidectomy without vocal cord paralysis: Analysis of 2,297 thyroidectomy patients. Surgery 2020; 168:1086-1094. [PMID: 32919781 DOI: 10.1016/j.surg.2020.07.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/16/2020] [Accepted: 07/28/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Some patients experience long-term voice change after thyroidectomy. One of the most common symptoms of voice change is pitch lowering, which is closely related to unfavorable voice quality. Here we observed voice outcomes for 6 months of follow-up after thyroidectomy to identify factors closely related to low-pitched voice. METHODS We retrospectively reviewed the records of 2,297 patients who underwent thyroidectomy between January 2014 and December 2017. All the patients had their vocal status examined using videostroboscopy, acoustic voice analyses, aerodynamic study, and Thyroidectomy-Related Voice Questionnaire scores. We stratified patients into 2 groups (low-pitched voice versus favorable voice) according to pitch lowering (reduction in speaking fundamental frequency ≥12 Hz 1 month after thyroidectomy compared to the preoperative value). We compared preoperative data with postoperative data collected 1, 3, and 6 months after thyroidectomy to identify factors contributing to low-pitched voice. RESULTS Univariate logistic regression analyses showed that factors related to low-pitched voice were female sex, older age, low body weight, short stature, and a high positive lymph node ratio. Multivariate analyses showed that female sex and older age were significantly associated with a negative prognosis for low-pitched voice 1 month after thyroidectomy (odds ratios 0.41 and 1.04, respectively; P < .001). Receiver operating characteristic curves for predicting sustained low-pitched voice during 6 months showed that speaking fundamental frequency ≥12.48 Hz 1 month after thyroidectomy was the optimal cutoff value, with 87.9% sensitivity and 95.8% specificity (P < .001). CONCLUSION Female sex and older age are strongly associated with increased risk for low-pitched voice after thyroidectomy. Speaking fundamental frequency ≥12.48 Hz 1 month after thyroidectomy can be used to predict sustained low-pitched voice after thyroidectomy.
Collapse
Affiliation(s)
- Sang-Yeon Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Geun-Jeon Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Hyun Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ja-Seong Bae
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - So-Hee Lee
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeong-Soo Kim
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeon-Shin Hwang
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mi-Ran Shim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Hak Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Il Sun
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| |
Collapse
|
23
|
Anatomical study of gasless transoral thyroidectomy and clinical application. Surg Endosc 2019; 34:3414-3423. [PMID: 31531736 DOI: 10.1007/s00464-019-07117-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 09/04/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Transoral thyroidectomy is becoming a preferred technique because it has the advantage of not leaving a scar after surgery. However, it is not yet standard because of the anatomic nerve complexity of this oral cavity and difficulty of approach. The aim of this study was to determine the safety zone of a gasless transoral thyroidectomy approach using an anatomical study and to evaluate the efficacy of this approach on clinical application. METHODS Phase 1, twenty unilateral specimens from fresh cadavers underwent staining by the modified Sihler's method to identify nerves around the oral vestibules. Then, the safety zone of the transoral thyroidectomy approach was proposed. Phase 2, a comparative analysis of the clinical outcomes of gasless transoral thyroidectomy through the safety zone versus transcutaneous thyroidectomy approach. RESULTS In phase 1, numerous inferior labial branches diverged from the mental nerve and were distributed across the lower lip. In most cases, the most lateral branch reached almost to the corner of the mouth, whereas a nerve-free area was present at the medial region of the lower lip. The suggested safety zone was presented as a trapezoid shape. In phase 2, there were no significant differences in age, mass size, or complications between the two groups. However, the operation time in the transoral thyroidectomy group was longer than in the transcutaneous group (p = 0.001). CONCLUSIONS Based on the anatomical study, we suggested a safety zone for the gasless transoral thyroidectomy. On application of this safety zone, gasless transoral thyroidectomy is a safe and feasible procedure.
Collapse
|
24
|
Rodríguez-Torres J, López-López L, Cabrera-Martos I, Torres-Sánchez I, Ortíz-Rubio A, Valenza MC. Musculoskeletal neck disorders in thyroid cancer patients after thyroidectomy. Eur J Cancer Care (Engl) 2019; 28:e13053. [PMID: 31016824 DOI: 10.1111/ecc.13053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 02/14/2019] [Accepted: 03/25/2019] [Indexed: 11/29/2022]
Abstract
Thyroid cancer (TC) is the most common type of cancer in the endocrine system, and thyroidectomy is the preferred treatment. Complications associated are still common and 80% of patients complain of posterior neck pain. The aim of this study was to analyse the long-term musculoskeletal disorders in TC patients who had undergone thyroidectomy. An observational case-control study was carried out. Twenty-eight patients who had undergone thyroidectomy and 28 healthy control patients were included. Outcomes were collected 6 months after surgery and included: musculoskeletal neck disorders (neck range of movement, trigger points) and functional variables (pain intensity and disability). Significant differences were found between groups in flexion (p = 0.002) and extension (p = 0.005), with lower values in the thyroidectomy group. The number of trigger points was higher in the thyroidectomy group in both scalenes (p < 0.001), both sternocleidomastoids (p < 0.001), both upper trapezius (p = 0.005 and p = 0.008), right levator scapulae (p = 0.002) and both suboccipitalis (p = 0.002). Pain intensity (p < 0.001) and the Neck Outcome Scale subscales (p < 0.05) also presented significant differences. Thyroidectomy patients, 6 months after surgery, show a significant decrease in neck range of movement and an increase in the number of trigger points. They also show greater pain intensity and more disability.
Collapse
Affiliation(s)
- Janet Rodríguez-Torres
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Laura López-López
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Cabrera-Martos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Torres-Sánchez
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Araceli Ortíz-Rubio
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Marie C Valenza
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| |
Collapse
|
25
|
Lee JS, Kim JP, Woo SH. Re: Comments on effect of wound massage on neck discomfort and voice change after thyroidectomy. Surgery 2018; 165:664-667. [PMID: 30554727 DOI: 10.1016/j.surg.2018.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 10/30/2018] [Accepted: 10/31/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Jae Seok Lee
- Department of Otolaryngology, Gyeongsang National University Hospital, Jinju, Korea
| | - Jin Pyeong Kim
- Department of Otolaryngology, Gyeongsang National University Hospital, Changwon, Korea; Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea, 660-702
| | - Seung Hoon Woo
- Department of Otolaryngology, Gyeongsang National University Hospital, Jinju, Korea; Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea, 660-702.
| |
Collapse
|
26
|
M S, Mouli V S, Singh KR, Ramakant P, Mishra AK. Comments on: Effect of wound massage on neck discomfort and voice changes after thyroidectomy. Surgery 2018; 165:664-667. [PMID: 30377000 DOI: 10.1016/j.surg.2018.08.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 08/27/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Shreyamsa M
- Department of Endocrine Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.
| | - Sasi Mouli V
- Department of Endocrine Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Kul Ranjan Singh
- Department of Endocrine Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Pooja Ramakant
- Department of Endocrine Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anand Kumar Mishra
- Department of Endocrine Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|