Does Postthyroidectomy Syndrome Really Exist Following Thyroidectomy? Prospective Comparative Analysis of Open vs. Endoscopic Thyroidectomy

Abstract

ObjectivesThis study prospectively evaluated postthyroidectomy syndrome (PTS) through objective and subjective voice changes following thyroidectomy of open vs. endoscopic thyroidectomy.MethodsA prospective clinical trial (SCHBC IRB 09 26) was performed from Jan 2008 to Aug 2010 to compare the open thyroidectomy (OPEN group) and endoscopic thyroidectomy (ENDO group). Of the 110 patients, 75 completed the evaluation before and 1 and 6 months after surgery. Subjective parameters included perceptual analysis (GRBAS [grade, roughness, breathiness, asthenia, and strain] scale), stroboscopic or flexible fiberscopic analysis, voice handicap index, and 5-point visual analog scales for vocal fatigue, singing difficulty, difficulty with high-pitch phonation, and neck discomfort. Objective parameters included acoustic, aerodynamic analysis and the electroglottograph.ResultsFor the ENDO group (n=36), the operation time was longer than in the OPEN group (n=39; P<0.01). For the OPEN group, two objective and five subjective parameters were worse 1 month postoperatively; of these, two subjective parameters persisted for 6 months (P<0.05). For the ENDO group, three objective and six subjective parameters were worse 1 month postoperatively, and three of the subjective parameters persisted 6 months postoperatively (P<0.05).ConclusionPTS really exists following simple thyroidectomy and are very common for both OPEN and ENDO groups. Most of the parameters improved gradually over time, but some subjective changes persisted 6 months postoperatively.

Changes in Voice- and Swallowing-Related Symptoms After Thyroidectomy: One-Year Follow-Up Study

“…Other complaints include abnormal sensations in the neck area, vague voice changes, and unexplained neck discomfort. 2 These symptoms are referred to as thyroid surgery–related voice changes or PTS. 2,8 However, although many patients complain of various uncomfortable symptoms after thyroidectomy, the precise mechanisms involved are still unknown.…”

“…2 These symptoms are referred to as thyroid surgery–related voice changes or PTS. 2,8 However, although many patients complain of various uncomfortable symptoms after thyroidectomy, the precise mechanisms involved are still unknown. Although the laryngotracheal fixation between the trachea and strap muscles is considered the most plausible cause, it is believed that SLN or pharyngeal plexus injury and postoperative lymphatic edema are also involved.…”

Intraoperative Neuromonitoring Using a Single Transcartilage Needle Electrode During Thyroidectomy

“…Exposure of only the inferior third at the ipsilateral side of thyroidectomy with only one electrode insertion may be simpler and easier to conduct. Because laryngotracheal fixation with strap muscles may lead to postthyroidectomy dysphonia or discomfort, 16 unnecessary dissection of the thyroid cartilage during thyroidectomy should be avoided.…”

Association between postoperative cough and thyroidectomy: a prospective study

“…Cough occurs frequently following surgical procedures, and its exact cause remains unclear [13, 14]. Several authors have reported that a considerable number of patients have complaints of cough after lung and abdominal surgery [15, 16].…”