Thyroidectomy-related Swallowing Difficulties: Review of the Literature

Đanić-Hadžibegović, Ana; Hergešić, Filip; Babić, Ema; Slipac, Juraj; Prstačić, Ratko

doi:10.20471/acc.2020.59.s1.05

Cited by 4 publications

(4 citation statements)

References 70 publications

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“…At the same time, it should be noted that oropharyngeal dysphagia affects approximately 20%–80% of patients after thyroidectomy, although it is usually an undiagnosed problem in this patient population (Hadžibegović et al., 2020; Hashemian et al., 2019). The most common symptoms reported by this group of patients are discomfort sensation in the pharynx, ʻforeign body’ feeling, odynophagia, paroxysmal cough and hypersalivation feeling.…”

Section: Discussionmentioning

confidence: 99%

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The risk factors for silent aspiration: A retrospective case series and literature review

Jamróz,

Sobol,

Chmielewska‐Walczak

et al. 2024

Intl J Lang & Comm Disor

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AimEvidence shows that 20%–30% of patients who aspirate do so silently. Research to date has not demonstrated clear evidence to indicate which patients are at higher risk of silent aspiration. Our aim was to use univariate logistic regression analysis of retrospective case review to determine potential patterns of silent aspiration.Materials and methodsWe conducted a retrospective analysis of 455 fiberoptic endoscopic evaluation of swallowing (FEES) reports. The patients were divided into four groups: G1 – neurological diseases (n = 93), G2 – head and neck surgery (n = 200), G3 – gastroenterological diseases (n = 94) and G4 – other patients (n = 68). Data included the occurrence or absence of saliva penetration or aspiration, of silent fluid/solid food penetration or aspiration, type of penetration or aspiration, occurrence of cranial nerve paresis, radiotherapy and tracheostomy. Univariate logistic regression was used to evaluate independent risk factors of silent aspiration in the study population. Three models with different independent variables were considered.ResultsThere is a statistically significant difference in the frequency of occurrence of silent penetration and aspiration within the groups (p < 0.001), with intraglutative being most frequent. Fluid and food penetration and aspiration correlated with saliva penetration and aspiration in all groups (p < 0.001). Cranial nerve paresis (IX and X), radiotherapy and tracheostomy correlate with saliva penetration and aspiration (p = 0.020 for cranial nerve paresis; p = 0.004 for radiotherapy; p < 0.001 for tracheostomy). One hundred and fifteen patients (45.81%) in the subgroup of patients with intraglutative aspiration had cranial nerve paresis (IX, X or IX–X).ConclusionsPatients who should be prioritised or considered to be at a higher need of instrumental swallowing evaluation are those with IX and X cranial nerve paresis, tracheostomy and those who have had radiotherapy, with saliva swallowing problems, especially after paraganglioma, thyroid and parathyroid glands and middle and posterior fossa tumour surgery.WHAT THIS PAPER ADDSWhat is already known on the subject Clinical signs of penetration or aspiration include coughing, throat clearing and voice changes, while silent penetration or aspiration patients aspirate without demonstrating any clinical symptoms. The most common consequences of silent aspiration include aspiration pneumonia, recurrent lower respiratory tract infections and respiratory failure. Additionally, malnutrition and dehydration can be indicators of silent aspiration. Patients may unknowingly reduce their oral intake and lose weight. Retrospective studies have shown that 20%–30% of patients aspirate silently (e.g. patients after stroke, acquired brain injury, head and neck cancer treatment, prolonged intubation). Clinical examination of swallowing can miss up to 50% of cases of silent aspiration.What this paper adds to existing knowledge Currently, silent aspiration is often discussed in neurological literature, but its applications to head and neck surgery are limited. In this study, we identify head and neck surgery patients who should be prioritised or considered to be in higher need of instrumental swallowing evaluation due to a higher risk of silent aspiration.What are the potential or actual clinical implications of this work? Post‐treatment structural changes can result in lower cranial nerve paresis (IX, X, XII) and face injury, in which vagus and glossopharyngeal nerves are injured. After tracheostomy and radiotherapy, patients with problems swallowing saliva need careful clinical examination, particularly cranial nerve examination.

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Section: Discussionmentioning

confidence: 99%

“…Symptoms usually resolve within 3 months but can last longer in 20% of patients. A review of the literature on this issue by Hadzibegovic et al showed that there is no standardized protocol for dealing with dysphagia associated with total thyroidectomy (Hadžibegović et al, 2020).…”

Section: Effect Of Cranial Nerve Paresismentioning

confidence: 99%

The risk factors for silent aspiration: A retrospective case series and literature review

Jamróz,

Sobol,

Chmielewska‐Walczak

et al. 2024

Intl J Lang & Comm Disor

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“…Patients submitted to thyroidectomy may have vocal and swallowing alterations even with the preservation of the laryngeal nerves (3,4,24) , which impact the individual's quality of life and emotional state (25) . The understanding and identification of these parameters helps in clinical decision-making and in better communication in the professional-patient relationship.…”

Section: Discussionmentioning

confidence: 99%

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

Depolli,

Oliveira,

Oliveira

et al. 2023

CoDAS

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Purpose To correlate the dysphagia quality of life and symptoms of anxiety and depression before and after thyroidectomy. Methods Observational, longitudinal, prospective, and experimental study. Twenty patients participated, with a mean age of 54 years, prevalence of females (n=17; 85%) and partial thyroidectomy (n=14; 70%). All subjects underwent laryngeal visual examination and answered the MD Anderson Dysphagia Questionnaire (MDADI) and the Hospital Anxiety and Depression Scale (HADS) in three different moments: preoperatively, immediately postoperatively (maximum one week) and three months after surgery. Results There was a significant difference in dysphagia quality of life for the physical and total domains in the three different moments. Regarding anxiety and depression, a statistically significant difference was observed between the scores in all domains, with a greater difference observed between the preoperative period and after 1 week. Higher values were observed in the preoperative period for mild anxiety traits, being more frequent in relation to depression, with a reduction after 1 week and an increase after three months of surgery. There was no significant correlation between the MDADI and HADS protocols. Conclusion Patients undergoing thyroidectomy self-report better quality of life in dysphagia and reduced anxiety/depression scores after three months of surgery. There was no correlation between anxiety, depression and quality of life in dysphagia at the moments evaluated.

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“…Since nerve fibers and blood vessels that supply muscle cells with blood can be damaged or altered, postoperative dysphagia is often associated with surgical interventions for paratracheal tumors or hyperthyroidism [10,11]. During surgery, the most common complications of thyroidectomy are bleeding and hematomas.…”

Section: Figure 1 Distribution Of Patients By Pathology Gendermentioning

confidence: 99%

Complications after Surgery on the Thyroid Gland: A Review

Kalion,

Stepanova,

Gaziev

et al. 2024

Arch Pharm Pract

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It is recommended to perform thyroid surgery for many reasons. The most important one is to diagnose thyroid tumors through fine needle biopsy. This method remains the gold standard for evaluating nodules. There has been a significant increase in thyroid carcinoma cases in Russia in the last 15 years. This can be attributed to better and more systematic diagnosis methods that allow the detection of even very small cancers. In addition, tumors from Hurthle-cells warrant surgery, at the very least lobectomy. This is because pathohistological diagnostics is still the most reliable way to distinguish benign tumors from malignant ones. It should be noted that patients should receive proper advice regarding potential complications before any surgical intervention, they should be fully aware of all possible risks. This review looks at mild (seroma) and severe (recurrent neural damage, hypoparathyroidism, bleeding, and seroma) complications that can occur after thyroid surgery. This review examines the possibilities for treatment and prevention of each of these complications.

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Thyroidectomy-related Swallowing Difficulties: Review of the Literature

Cited by 4 publications

References 70 publications

The risk factors for silent aspiration: A retrospective case series and literature review

The risk factors for silent aspiration: A retrospective case series and literature review

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

Complications after Surgery on the Thyroid Gland: A Review

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