The Impact of Goiter and Thyroid Surgery on Goiter Related Esophageal Dysfunction. A Systematic Review

Sørensen, Jesper Roed; Bonnema, Steen Joop; Godballe, Christian

doi:10.3389/fendo.2018.00679

Cited by 9 publications

(4 citation statements)

References 50 publications

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“…Benign nodular goiter may result in a range of symptoms, including difficulties in swallowing and neck pressure symptoms [1][2][3][4]. Patients undergoing thyroidectomy often experience an improvement in quality of life (QoL) three to six months after surgery [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Post‐Thyroidectomy Neck Stretching Exercises on Neck Discomfort, Pressure Symptoms, Voice and Quality of Life: A Randomized Controlled Trial

et al. 2022

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Background Following surgery for benign nodular goiter, patients may experience neck and shoulder pain, neck pressure and tightness, choking sensation, altered voice function, and dysphagia leading to decreased short-term quality of life (QoL). This single-blinded randomized controlled trial investigated the effect of post-thyroidectomy rehabilitative neck stretching and movement exercises on these variables including QoL. Methods Patients undergoing thyroid lobectomy or total thyroidectomy were randomized to perform neck stretching and movement exercises three times daily in four weeks following surgery (intervention group) or conventional follow-up without exercises (control group). Outcome measures were scores in the following questionnaires: Disease-specific Thyroid-Related Patient-Reported Outcome (ThyPRO-39) involving symptoms of “sense of fullness in the neck,” “pressure in the throat,” and “discomfort swallowing” combined in the multi-item Goiter Symptom Scale, the Voice Handicap-Index-10 (VHI-10), neck and shoulder pain measurement by a numeric rating scale (NRS), and General measure of health (EQ-5D-5L). All scores were assessed prior to surgery and one, two, four weeks, and three months after surgery. Data were analyzed using a linear mixed model. Results Eighty-nine patients were included and randomized to the control ( n = 45) or the intervention group ( n = 44). At three months after surgery, both the control and the intervention group experienced large to moderate improvements in the Goiter symptom and Hyperthyroid symptom scale of the ThyPRO questionnaire ( p < 0.004). No significant between-group differences were found in any of the other applied scales. Conclusions This study confirms that patients experience profound improvements in QoL after surgery for benign nodular goiter. However, early post-thyroidectomy neck stretching and movement exercises did not result in further QoL improvement, reduction in pain or less impacted subjective voice function for patients primarily undergoing thyroid lobectomy. Trial Registration Number NCT04645056 ( https://clinicaltrials.gov )

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Section: Introductionmentioning

confidence: 99%

The Impact of Post‐Thyroidectomy Neck Stretching Exercises on Neck Discomfort, Pressure Symptoms, Voice and Quality of Life: A Randomized Controlled Trial

et al. 2022

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“…Reported recurrence rates have not been consistent in the literature, with the average time for recurrence being 10–16 years. Not all patients who have recurrence require reoperation, it was reported that about 10% of patients with unilateral disease might develop recurrence in the long term, but only half will need surgical treatment [ 24 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of hemi-thyroidectomy in relieving compressive symptoms in cases with large multi nodular goiter

Alsaleh

Albaqmi

Alaqel

2021

Annals of Medicine &Amp; Surgery

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Introduction and importance This case series describe the efficacy of hemi-thyroidectomy to relieve the compressive symptoms of cases having large multi-nodular goiter with preservation of the thyroid gland function. It's considered as an education tool for surgeons to perform safe hemi thyroidectomy to patients indicated for total removal of the gland. Compressive symptoms like mild/severe dysphagia or dyspnea associated with both benign and malignant thyroid disease. Although total thyroidectomy is currently considered the standard of care, hemi thyroidectomy is another surgical option with more benefits. Case presentation This case series was performed in a tertiary university hospital in Riyadh, Saudi Arabia. It included 35 females and 3 males above the age of 18 (mean age 42 years). All the operations were elective hemi-thyroidectomies performed by one surgeon, during 2019. Patients were complaining of; Voice Change, Neck Swelling, Dysphagia, Chocking, SOB, and Orthopnea. 20 of them were medically free and 18 patients had multiple associated comorbidities. Clinical findings and investigations Demographic data, baseline co-morbidities, TSH levels prior to surgery, thyroid gland size, FNA results and pre-operative symptoms were recorded. In addition, compressive symptomatology outcomes from two weeks to two years were recorded. Thirty-two of them (84%) had their symptoms resolve completely and did not need a completion surgery. Out of the 6 who had persistent symptoms, only two needed a completion surgery. Furthermore, only 34.2% required thyroid hormone replacement, 31.6% were euthyroid and 2.6% were hypothyroid preoperatively. Interventions and outcome Hemi thyroidectomy was chosen to avoid the risk of hormone replacement, and hypocalcemia. Our results revealed that compressive symptoms were effectively relieved in the majority of our patients. Only 2 patients had to undergo completion thyroidectomy due to compressive symptoms with no perioperative or postoperative complications. Relevance and impact We would recommend hemi thyroidectomy for cases of large multi nodular goiter due to its positive implication on patient outcome particularly if the patient refuse hormonal replacement.

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“…The incidence of retrosternal extension of thyroid goiters may therefore range greatly between 2.6% and 30.4% 4-7 according to the definition used. Causes include various genetic and environmental factors 8 .…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of retrosternal extension of thyroid goiters may therefore range greatly between 2.6% and 30.4% [4][5][6][7] according to the definition used. Causes include various genetic and environmental factors 8 . Surgery is indicated for retrosternal goiter in the presence of compression symptoms or potential airway compromise and to treat thyroid malignancy.…”

Section: Introductionmentioning

confidence: 99%

Extended cervical approach for retrosternal multinodular goiter

Tsur,

Levi,

Frig

et al. 2024

Acta Otorhinolaryngol Ital

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SUMMARY Objective Partial or total sternotomy is required for 10% of retrosternal goiter. This study reviewed our experience with an extended cervicotomic approach as an alternative surgical solution for retrosternal goiter. Methods A retrospective study was performed on patients who underwent partial or total thyroidectomy for retrosternal goiter between 2014 and 2019 at a tertiary medical centre. Data on clinical, radiologic, and pathologic factors were analysed. Peri- and postoperative outcomes were compared between extended and standard cervical approaches to predict the need for an extended cervical approach. Results The cohort included 265 patients, of whom 245 (92.4%) were treated by standard thyroidectomy. In 17 (6.4%), the standard approach proved insufficient, and the horizontal incision was extended to a T-shape to improve access. The remaining 3 patients required a sternotomy. Use of the extended cervical approach was significantly associated with clinical features such as male gender, diabetes, high body mass index and postoperative hypocalcaemia. Conclusions The extended cervicotomic approach is an alternative surgical solution for retrosternal goiter, with no increased risk of significant post-operative complications.

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The Impact of Goiter and Thyroid Surgery on Goiter Related Esophageal Dysfunction. A Systematic Review

Cited by 9 publications

References 50 publications

The Impact of Post‐Thyroidectomy Neck Stretching Exercises on Neck Discomfort, Pressure Symptoms, Voice and Quality of Life: A Randomized Controlled Trial

The Impact of Post‐Thyroidectomy Neck Stretching Exercises on Neck Discomfort, Pressure Symptoms, Voice and Quality of Life: A Randomized Controlled Trial

Effectiveness of hemi-thyroidectomy in relieving compressive symptoms in cases with large multi nodular goiter

Extended cervical approach for retrosternal multinodular goiter

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