Thyroid Resection Improves Perception of Swallowing Function in Patients with Thyroid Disease

Abstract

Background Patients with thyroid disease frequently complain of dysphagia. To date, there have been no prospective studies evaluating swallowing function before and after thyroid surgery. We used the swallowing quality of life (SWAL-QOL) validated outcomes assessment tool to measure changes in swallowing-related quality-of-life in patients undergoing thyroid surgery. Methods Patients undergoing thyroid surgery from May 2002 to December 2004 completed the SWAL-QOL questionnaire before and one year after surgery. Data were collected on demographic and clinicopathologic variables, and comparisons were made to determine the effect of surgery on patients’ perceptions of swallowing function. Results Of 146 eligible patients, 116 (79%) completed the study. The mean patient age was 49 years, and 81% were female. Sixty-four patients (55%) underwent total thyroidectomy and the remainder received thyroid lobectomy. Thirty patients (26%) had thyroid cancer. The most frequent benign thyroid conditions were multinodular goiter (28%) and Hashimoto’s thyroiditis (27%). Mean pre-operative SWAL-QOL scores were below 90 for nine of the eleven domains, indicating the perception of impaired swallowing and imperfect quality of life. After surgery, significant improvements were seen in eight SWAL-QOL domains. Recurrent laryngeal nerve injury was associated with dramatic score decreases in multiple domains. Conclusions In patients with thyroid disease, uncomplicated thyroidectomy leads to significant improvements in many aspects of patient-reported swallowing-related quality-of-life measured by the SWAL-QOL instrument.

Prevalence of voice & swallowing complaints in Pre-operative thyroidectomy patients: a prospective cohort study

“…Swallowing dysfunction is a commonly reported symptom in pre-operative thyroidectomy patients, with the majority complaining of a globus sensation [1,[3][4][5]7,18]. In our cohort, 47.2% of patients reported swallowing symptoms at least some of the time, with 27.1% reporting symptoms often or always; with the majority of symptoms relating to a globus sensation.…”

“…A literature review found that the reported prevalence of compressive symptoms in pre-operative thyroidectomy patients varied widely between studies, ranging from 11-88% [1][2][3][4][5][6][7]. Unfortunately many of these studies vary with regards to the symptoms reported as well as the methods used for data collection (e.g.…”

“…Whether these symptoms are indeed secondary to thyroid pathology or are due to a different process is often unclear. A review of the literature found the reported prevalence rates of voice and swallowing symptoms in pre-operative thyroidectomy patients to vary widely between 11-88% [1][2][3][4][5][6][7].…”

“…Although many of these studies report an improvement or resolution of compressive symptoms following thyroidectomy, a number of patients continue to experience voice and swallowing complaints post-operatively [4][5][6][7][8]. Due to the non-specific nature of these complaints, and the possibility of other underlying etiologies, the true prevalence of voice and swallowing symptoms due to thyroid pathology remains unclear.…”

The Impact of Esophageal Compression on Goiter Symptoms before and after Thyroid Surgery

“…Nodular goiter can lead to a wide range of symptoms including swallowing discomfort and respiratory disturbances, which can have a negative impact on quality of life (QoL) [1, 5, 6]. A clear correlation between goiter volume, tracheal compression, and relief from this compression following thyroidectomy is seen in patients with benign goiter [7], but little is known concerning the impact of goiter on the esophagus.…”