Qualidade de vida relacionada à voz e à deglutição, a curto prazo, em pacientes submetidos à radioiodoterapia por carcinoma diferenciado de tireoide

Abstract

Qualidade de vida relacionada à voz e à deglutição, a curto prazo, em pacientes submetidos à radioiodoterapia por carcinoma diferenciado de tireoide José Ribamar do Nascimento Junior (1) , Elisabete Carrara-de Angelis (2) , Eduardo Nóbrega Pereira Lima (3)Instituto de Gerenciamento em deglutição -IGD São Paulo, SP, Brasil.Departamento de Fonoaudiologia do Hospital AC Camargo São Paulo, SP, Brasil.Departamento de Medicina Nuclear do Hospital AC Camargo, São Paulo, SP, Brasil. Conflict of interest: non-existentThe main structures at risk during thyroid surgery are the recurrent laryngeal nerves and parathyroid glands. The removal of the parathyroid glands can lead to hypoparathyroidism and consequent hypocalcemia 1,3 . Lesion to the inferior recurrent laryngeal nerve can result in vocal fold paralysis, which may cause permanent hoarseness. If the lesion is bilateral, aphonia and dyspnea are results of changes in the vocal folds 4 .In thyroid surgery, its comorbidities is postsurgical therapy with ¹³¹I leading to prolonged survival, and patients may present vocal alterations, dysphagia, sialadenitis, taste changes and xerostomia 5 .Sialadenitis is a possible side effect seen in treatment with high doses of ¹³¹I and correlates with the amount administered and physiological uptake, usually bilateral, in the region of the parotid or submandibular glands, which occurs within 48 INTRODUTCIONDiseases of the thyroid gland are common, affecting approximately 11% of the general population, with a predominance of female involvement over male in a ratio of 4:1 1 . The initial treatment of well-differentiated thyroid carcinoma consists in most cases of total or near total thyroidectomy with subsequent remnant ablation with iodine radioisotope (¹³¹I) followed by L-thyroxine (L-T4) suppression 2 . ABSTRACTPurpose: to analyze the quality of life related to voice and swallowing before and after radioiodine therapy in the short term. Methods: thiroidectomized individuals indicated RAI underwent two questionnaires on quality of life related to voice and swallowing before and three months after radioiodine therapy. Results: 32 patients, 84 % female and 16% male, were studied with a mean age of 46 years. The histological type was the classic papillary carcinoma (56%). The results indicated a tendency for better quality of life with respect to voice three months after radioiodine therapy. The protocol for quality of life related to swallowing also indicated better quality of life in the second assessment. A larger with minimal limitation on the quality of life questionnaire in swallowing was observed. Conclusion: quality of life and voice and swallowing symptoms in the short term after radioiodine therapy is better compared to pretreatment. It is necessary to investigate other aspects such as metabolic, surgical and individual to define the real impact of radioiodine therapy on quality of life.

Quality of life in dysphagia and anxiety and depression symptoms pre and post-thyroidectomy

“…The statistically significant difference found in this study between the "physical" and "total" MDADI domains is in line with a Brazilian study carried out with patients with thyroid carcinoma, which found an improvement in the scores of all MDADI domains after three months of treatment with radioiodine therapy (26) . Although the treatment method was different from the treatment of the participants in this study, the difference between the scores of the domains in both studies strengthens the hypothesis that both thyroidectomy and radioiodine therapy can improve the quality of life related to swallowing in patients with thyroid disorders.…”

O processo comunicacional dos adoecidos pelo câncer de laringe

“…Sobre a qualidade de vida relacionada à voz, os estudos desta revisão são medidas importantes para serem avaliadas tendo vista a funcionalidade e a qualidade de vida dos pacientes com ccp na perspectiva de promover a comunicação com os adoecidos pelo CCP. A qualidade de vida relacionada a voz foi identificada como sendo maior em pacientes com câncer de tireóide anteriomente submetidos a iodoterapia, porém os impactos do tratamento se mantiveram discretos em 99% dos pacientes e os que estavam em nível grave passaram ao nível moderado (NASCIMENTO JUNIOR, et al, 2015).…”