Aggravation of Reflux Finding Score (RFS) after thyroidectomy

Abstract

Laryngopharyngeal reflux (LPR) has been suggested as a possible cause of post-thyroidectomy syndrome. However, the pathophysiology and relationship between thyroidectomy and LPR have not been well investigated. We aimed to evaluate the correlation between thyroidectomy and LPR by assessing changes in LPR-related symptoms and laryngoscopic findings before and after thyroidectomy. Ninety-five patients who underwent thyroidectomy with or without central neck dissection were included. The reflux finding score (RFS) and reflux symptom index (RSI) were investigated one day before surgery and two, four, six, and twelve months after surgery. The RFS scores increased significantly after thyroidectomy and decreased to the preoperative level 12 months after surgery. The RSI scores increased after surgery and decreased gradually by 12 months postoperatively, although it was not statistically significant. The RSI and RFS scores improved with the administration of proton pump inhibitors. In conclusion, LPR-related laryngoscopic findings were exacerbated after uncomplicated thyroidectomy. Further studies using pH-monitoring and esophageal manometry are required to investigate the possible deterioration of LPR itself and the UES pressure after thyroidectomy.

Post‐thyroidectomy voice and swallowing disorders and association with laryngopharyngeal reflux: A scoping review

“…15,17,21 The rest of the authors included both benign and malignant lesions. 14,[18][19][20]22,23 3.1 | Swallowing and voice outcomes…”

“…Some authors included only patients with carcinoma (and potential neck dissection), 13 whereas others focused on patients with benign lesions 15,17,21 . The rest of the authors included both benign and malignant lesions 14,18–20,22,23 …”

“…A total of 122 articles were identified and 13 papers met our inclusion criteria (Figure 1 ). 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 Among them, two studies did not investigate the association between PVSS and reflux and were excluded. 4 , 24 One study focused on stomach physiology throughout the thyroidectomy.…”

“…Authors included patients who benefited from total thyroidectomy, 13 , 14 , 15 , 17 , 18 , 19 , 20 , 21 or both partial and total thyroidectomy. 16 , 22 , 23 The indications of thyroidectomy are reported in Table 1 . Some authors included only patients with carcinoma (and potential neck dissection), 13 whereas others focused on patients with benign lesions.…”

“…23 Note that in the study of Yoon et al, postthyroidectomy RSI and RFS improved in patients treated with proton pump inhibitor. 23 From a basic science standpoint, Xiaoli et al 18 assessed the gastric secretion of acid and gastrin during total thyroidectomy and did not find significant changes throughout the surgery times.…”