Patient Perception of Swallowing after Thyroidectomy in the Absence of Laryngeal Nerve Injury

Abstract

Introduction: Swallowing and voice alterations may manifest in patients with thyroid disease, especially after thyroidectomy. Objective: To identify the prevalence of patients with complaints of swallowing disorders after thyroidectomy and to evaluate patients' perceptions regarding swallowing before and after the procedure. Methods: A prospective longitudinal study was performed with 26 consecutive patients undergoing a private service thyroidectomy, in which the presence of swallowing dysfunction was evaluated using validated questionnaires that addressed the perception of swallowing by patients before (on the day of surgery) and after the surgery (on the first postoperative day). Results: Of the 26 patients, 18 (69.2%) were subjected to total thyroidectomy and 8 to partial thyroidectomy. Analysis of the domains of the Swallowing Handicap Index questionnaire showed higher scores when evalu

Voice- and swallowing-related symptoms after total thyroidectomy: evidence from a Brazilian national survey

“…In general, the post-total thyroidectomy swallowingrelated symptoms were less perceived than the voice symptoms -although dry mouth/thirst was the second most prevalent symptom. "Dry mouth" had already been frequently mentioned by patients submitted to thyroidectomy in other Brazilian studies 11,[18][19] , even in the preoperative period 17,38 . However, no clear explanations are found for such a symptom in these patients.…”

“…The occurrence of voice symptoms after thyroidectomy ranges from 16% 8 to 36% 9 , while that of swallowing symptoms ranges from 20% to 58% 10 . Immediately after surgery, these proportions are even higher and may reach 69.2% and 80.8%, respectively 11 . The symptoms are possibly caused by laryngeal manipulation 12 , surgery time 8,13 , type of surgical technique used 14 , dissection of the cervical muscles 13,15 , orotracheal intubation, hematoma, stretching and fixing the cervical muscles, lesions in the superior and inferior laryngeal nerves 15 , besides the post-thyroidectomy syndrome, which occurs when there are complaints even in the absence of postoperative complications 12,16 .…”

“…The most common symptoms are reduced voice pitch, vocal fatigue, hoarseness, weak loudness, globus sensation, dry throat, and phlegm 2,7,8,[10][11][12][13][17][18][19][20][21][22] . Although these are temporary complications with a progressive improvement 23 , there is evidence of persistence of the symptoms through time 23,24 in up to 50% of the patients 2 , with a significant impact on their quality of life [10][11][12] .…”

“…In Brazil, the results of previous studies that investigated post-thyroidectomy symptoms related to voice and swallowing do not agree. Also, they were conducted only in hospital services in the Southeast 11,18,20 , Northeast 17,19 , or South Regions 21 of Brazil, with questionnaires whose psychometric properties are unknown [17][18][19][20][21] or not specific to this population 11 . The Thyroidectomy-Related Voice Questionnaire (TVQ) 6,25 has been internationally used with this purpose 6,7,23,[25][26][27][28][29] and already has a translated and transculturally adapted version in Brazilian Portuguese 30 .…”

A comparison of swallowing related quality of life in patients undergoing transoral endoscopic versus open thyroid surgery

“…The reason for changes in swallowing function could be injury to recurrent laryngeal nerves. However, dysphagia has been reported without the injury to these nerves and possible mechanisms suggested are surgical trauma, localized neck pain, cricothyroid muscle dysfunction, intraoperative injury of the thin anastomosis branches connecting the inferior laryngeal nerve and the external branch of the superior laryngeal nerve and/or one of its anastomoses with the sympathetic cervical chain, psychological reaction to surgery, manipulation of the peri‐thyroid muscles, as well as intubation, and healing 15–17 . As minimally, invasive surgery is associated with less surgical trauma due to magnified view, we wanted to compare the effects of two modes of surgical therapy on swallowing related quality of life which has not been done so far.…”