Autopercepção da deglutição em pacientes com doença tireoidiana benigna não cirúrgica

Abstract

RESUMO Objetivo verificar a frequência de queixa para deglutir em pacientes com doença tireoidiana benigna não cirúrgica e comparar a autopercepção de intensidade da alteração de deglutição em diferentes tipos de doença tireoidiana. Método a amostra do estudo foi composta por 39 mulheres com idades entre 19 e 58 anos (38,54 ± 10,74 anos) e diagnóstico de hipotireoidismo (n=22; 56,4%) ou nódulos tireoidianos (n=17; 43,6%). Investigou-se a presença de queixa, tipo de queixa e autopercepção da intensidade da alteração de deglutição por meio da escala analógico-visual de 100 milímetros. Os dados foram analisados de forma descritiva e para comparar a autopercepção entre os diferentes diagnósticos clínicos utilizamos o teste não paramétrico de Mann-Whitney. O nível de significância foi de 5%. Resultados vinte e seis (66,7%) participantes relataram queixa para deglutir. As queixas referidas foram sensação de estase em região laringofaríngea (37,15%), engasgo (34,29%) e odinofagia (28,57%). O valor médio da autopercepção de intensidade da alteração de deglutição por meio da escala analógico-visual foi 59,35 (± 27,38) milímetros. A autopercepção não foi diferente entre os diagnósticos clínicos de doença tireoidiana. Conclusão nessa amostra, queixas para deglutir foram frequentes em mulheres com doenças tireoidianas benignas não cirúrgicas. Essas pacientes percebem a alteração de forma moderada, independentemente do diagnóstico clínico da patologia tireoidiana.

Frequência combinada de queixas relacionadas à deglutição e voz antes da tireoidectomia

“…As expected, this group of patients had a higher number of symptoms in both functions compared to those whose self-assessment was positive. This result is in line with the literature, indicating that voice (1,11,(14)(15)(16)(18)(19)(20)(21) and swallowing (1,4,(13)(14)(15)(16)(17)(21)(22)(23) symptoms may be reported by patients referred for thyroidectomy. This is especially due to the compressive characteristics of thyroid disease, in addition to hormonal changes and impairment of laryngeal mobility or laryngotracheal complex (1,4) .…”

“…Thus, it is recommended that voice complaint be especially valued before thyroidectomy, as it may indicate the presence of multiple symptoms. Overall, the results of this study corroborate that patient perception seems to be an important measure in swallowing (8,12,15,17,(21)(22)(23) and voice (8,10,15,(19)(20)(21)(22)(23) assessment, as it can report subjective aspects not considered by the evaluator (17,19) . Based on the results, it can be inferred that swallowing and voice self-assessments should be considered in the care of patients referred for thyroidectomy, mainly because complaints in these two functions may appear concomitantly.…”

“…Stasis may also be referred to as a foreign body sensation in the throat and is cited in the literature as a frequent symptom in patients with thyroid disease (1,4,13,(15)(16)(17)21,22) . Therefore, it is assumed that in attempting to minimize the discomfort caused by the permanence of residues in the laryngopharynx, the patient develops throat clearing after swallowing, referred to in this study as the most frequent symptom among all related to swallowing.…”

“…However, voice and swallowing changes may be present even before thyroidectomy due to a possible hormonal disorder (1,2,4) . In addition, increased gland volume (1,11,12) and the presence of benign or malignant nodules (1,13,14) may cause compressive symptoms such as shortness of breath (1,13,14) , swallowing effort (1,4,14) , foreign body sensation in the throat (1,4,13,(15)(16)(17) , choking (17) , and odynophagia (1,4,13,17) , impacting the biomechanics of swallowing. Similarly, communication may be affected by vocal symptoms such as hoarseness, voice weakness, and monotonous voice (1,6,10,16) , as well as by physical symptoms such as throat clearing, pain and discomfort when speaking (18) .…”

“…Many studies on thyroidectomy have addressed preoperative occurrence of voice and swallowing symptoms in isolation (13)(14)(15)(16)(17)(18)(19)(20) , but the combined frequency of these conditions before surgery is unknown. Therefore, this study analyzes the combined frequency of voice and swallowing complaints before thyroidectomy.…”