The objective of this study is to assess the impact of perioperative dexamethasone on post-thyroidectomy voice outcomes. This study is a retrospective review of prospectively collected data in a tertiary referral center. This is a retrospective analysis of prospectively collected data on adult patients undergoing total thyroidectomy. Exclusion criteria were: previous neck surgery, thyroid lobectomy, neck dissection or other procedure together with thyroidectomy, pathological findings on laryngeal examination, preoperative or postoperative steroid therapy, diabetes mellitus, pregnancy, and postoperative recurrent laryngeal nerve palsy. In all patients, flexible laryngoscopy was performed and Voice Handicap Index (VHI) scores were obtained the day before, 48 h and 1 month after surgery. Patients' medical records were reviewed to find the patients who had received dexamethasone by the anesthesiologist as nausea and vomiting prophylaxis or analgesia. Thus, two groups of patients were formed: dexamethasone (D) group and non-steroid (NS) group. Mann-Whitney test used to compare VHI between the two groups. 122 patients fulfilled the criteria. D group consisted of 50 patients (44 females; mean age 53.16 ± 17.61), in which a single IV dose of 8 mg dexamethasone had been administered perioperative, and NS group consisted of 72 patients (58 females; mean age 50.53 ± 13.60), where no steroids had been administered. No significant difference was noticed between D and NS groups for preoperative VHI score, VHI scores 48 h and 1 month after surgery. In our study, a single perioperative IV dose of 8 mg dexamethasone did not seem to add any benefit on voice-related quality of life after thyroid surgery.
Dear Editor, Even though more than half of patients undergoing thyroidectomy complain of non-specific dysphagia, when no laryngeal nerve injury is involved the importance of this complication is often overlooked. 1-3 Post-thyroidectomy swallowing problems include non-specific swallowing changes and discomfort, occasional dysphagia, painful swallowing, swallowing difficulty and sensation of a lump or coughing. 3,4 These symptoms usually resolve after a short period 4 but sometimes may persist long after surgery. 2 Steroids are well known for their analgesic, antiinflammatory, immune-modulating and antiemetic effects. 5 Furthermore, evidence in the literature supports the perioperative use of corticosteroids in thyroid surgery as prophylaxis for post-operative nausea and vomiting 5-7 or analgesia. 5,6 In our department, it is a common practice of some anaesthesiologist to use perioperative steroids in thyroid surgery, while some others do not; so some of our patients receive perioperative steroids and others do not. To our knowledge, the impact of steroids on swallowing symptoms after thyroidectomy has never been evaluated so far (PubMed search).The purpose of this study was to evaluate the impact of a single perioperative dexamethasone administration on postthyroidectomy swallowing symptoms as expressed by swallowing impairment score (SIS-6) questionnaire. 8
Methods
Ethical considerationsCase notes and computer data only were used for this study complying with the regulations of University Hospital of Larissa scientific committee. This study was approved by the University Hospital of Larissa review board.
Participants and outcome measures
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.