Objective: To evaluate weight gain in children post-thyroidectomy and identify predictors. Methods: Charts from patients at a tertiary health care facility who underwent total thyroidectomy from 2014 to 2020 were reviewed for Body Mass Index z-scores (BMIz) at the time of thyroidectomy and at 1 and 2-year post-operation intervals. Patient demographic information, comorbidities, pre-and postoperative thyroid stimulating hormone, and postoperative free T4 levels were also extracted. Patients with other known endocrine abnormalities, chronic kidney disease, or without sufficient follow-up were excluded.Results: A total of 56 patients (ages 3-17 years old) met the inclusion criteria (n = 17 Graves' disease; n = 39 presumed cancer). Over the first year, average BMIz significantly increased in patients with Graves' disease (ΔBMIz = 0.45 AE 0.77, p = 0.03), Hispanic ethnicity (ΔBMIz = 0.43 AE 0.68, p = 0.004), Medicaid/no insurance coverage (ΔBMIz = 0.33 AE 0.74, p = 0.038), age <13 years at thyroidectomy (ΔBMIz = 0.35 AE 0.68, p = 0.016), and persistent postoperative hypothyroidism (ΔBMIz = 0.41 AE 0.41, p = 0.012). These changes remained significant after the second year. Age at thyroidectomy correlated negatively with ΔBMIz only after the first year (r = À0.40, p = 0.002). Regression analysis, controlling for Graves' status, persistent postoperative hypothyroidism, and insurance coverage, identified age at thyroidectomy as a significant predictor of ΔBMIz after the first year (b = À0.06, p = 0.004) and Hispanic ethnicity as a significant predictor after the second year (b = 0.60, p = 0.003).Conclusion: A small increase in BMIz post-thyroidectomy was observed across several patient subgroups. Younger age at thyroidectomy and Hispanic ethnicity were associated with increased BMIz in the first 2 years post-thyroidectomy.

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ObjectiveTo identify variables that are associated with poor compliance to thyroid hormone replacement therapy in children after total thyroidectomy.MethodA retrospective cohort study of children who underwent total thyroidectomy by high‐volume pediatric otolaryngologists between 1/2014 and 9/2021. Postoperative poor compliance was characterized by at least three separate measurements of high TSH levels not associated with radioactive iodine treatment.ResultsThere were 100 patients, ages 3–20 years old who met inclusion criteria; 44 patients underwent thyroidectomy for cancer diagnosis, and 56 for Graves' disease. The mean follow‐up time was 36.5 months (range 3.0–95.6 months). Overall, 42 patients (42%) were found to have at least three measurements of high TSH during follow‐up, and 29 patients (29%) were diagnosed with clinical hypothyroidism. Sex, race, income, insurance type, and benign versus malignant etiology for thyroidectomy were not associated with adherence to therapy. Multivariate regression analysis identified patients with Graves' disease and hyperthyroidism at the time of surgery and Hispanic ethnicity to be associated with postoperative clinical hypothyroidism (OR 9.38, 95% CI 2.16–49.2, p = 0.004 and OR 6.15, 95% CI 1.21–36.0, p = 0.033, respectively).ConclusionsPreoperative hyperthyroidism in patients with Graves' disease and Hispanic ethnicity were predictors of postoperative TSH abnormalities. Preoperative counseling for patients and their families on the implications of total thyroidectomy and the need for life‐long medications postoperatively is necessary. Efforts should be made to evaluate and improve adherence to therapy pre‐and postoperatively in patients with Graves' disease.Level of Evidence4 Laryngoscope, 133:2402–2406, 2023

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IntroductionDespite the known benefits of music therapy (MT) and its potential applications in an inpatient rehabilitation facility (IRF), there remains a lack of access to MT in a significant number of hospitals in the United States. Exploration of stakeholder (e.g., physician, therapist, and patient) perceptions as a potential barrier to uptake has been limited.ObjectiveTo assess the favorability of patients admitted to an IRF toward MT through the domains of knowledge, attitudes, and beliefs. We hypothesized that patient domain scores would reflect a favorable perception of MT across rehabilitation diagnoses.DesignDescriptive and cross‐sectional survey.SettingFree‐standing, acute IRF.PatientsA total of 119 English‐speaking, adult patients across three impairment categories (general rehabilitation, spinal cord injury, and brain injury) were recruited over a 3‐month period and during each patient's hospital stay.InterventionNot applicable.Main Outcome MeasuresA modified version of the Global Complementary/Alternative and Music Therapy Assessment (GCAMTA) measured the domains of knowledge, attitudes, and beliefs.ResultsAn overall response rate of 79.3% was achieved. Most patients (n = 95; 79.8%) scored in either the favorable or neutral ranges of the instrument. Age correlated negatively (r = −0.193, p < .05) with total score, whereas highest level of education correlated positively (rs = 0.222, p < .05). There were no significant differences in scores across impairment categories (V = 0.068, p = .232). Knowledge scores, controlling for education and age, predicted 30.4% of the variance in attitudes and beliefs scores (R2 = 0.304, p < .001).ConclusionsIt is unlikely that patient perceptions are a barrier to MT uptake. Younger, more educated patients have higher knowledge, attitudes, and beliefs about MT. Increasing patient knowledge about MT may improve their attitudes and beliefs, thereby further optimizing this therapy for widespread use.