Swallowing Problems after Thyroidectomy

Abstract

Introduction Thyroidectomy is a common procedure. Certain swallowing problems could happen after this surgery and affect the quality of life of the patient. Objective To evaluate swallowing after thyroidectomy in the early and late postoperative periods and to correlate subjective and objective parameters. Methods A prospective study with100 patients who underwent total thyroidectomy at our institution from April 2018 to September 2019. Each patient was assessed by the Arabic version of the Eating Assessment Tool (EAT-10) questionnaire and the fiberoptic endoscopic evaluation of swallowing (FEES) preoperatively, and in the early postoperative (EPO) and late postoperative (LPO) periods. Results The rate of dysphagia was of 82% in the EPO period, and of 36% in the LPO period. Two groups were compared regarding vocal fold mobility using the FEES. Group I included 89 patients with normal vocal fold mobility, 42% of whom had early dysphagia, and only 22% had late dysphagia. Regarding swallowing, we found that in the EPO period, the rates of delayed triggering, aspiration, penetration and residue were of 12.4%, 0%, 0%, and 42.7% respectively. Group II (unilateral immobile vocal fold) included 11 patients in the EPO evaluation, and all of them had early dysphagia. Conclusion Swallowing problems can occur in patients after thyroidectomy regardless of alterations in larynx mobility, and they are characterized by delayed triggering and stasis of food, which are also noticed in the LPO period, though more frequently in the EPO period. Moreover, there is a highly significant correlation between the subjective and objective parameters of swallowing in both EPO and LPO periods.

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

“…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.…”

Long‐term Quality of Life After Thyroidectomy: Transoral Endoscopic Thyroidectomy Vestibular Approach Versus Transcervical Approach

“…[16][17][18][19][20][21] Beyond scar-related morbidity, thyroidectomy has been associated with changes in general HRQOL and voice-and swallowing-related HRQOL. [22][23][24][25] This single American institution, cross-sectional study seeks to compare longterm quality of life between TOETVA and TCA groups using several validated HRQOL instruments.…”

“…However, HRQOL after TOETVA remains understudied, with only a few small investigations of HRQOL after surgery in mainly non‐North American populations 16‐21 . Beyond scar‐related morbidity, thyroidectomy has been associated with changes in general HRQOL and voice‐ and swallowing‐related HRQOL 22‐25 . This single American institution, cross‐sectional study seeks to compare long‐term quality of life between TOETVA and TCA groups using several validated HRQOL instruments.…”

A comparison of swallowing related quality of life in patients undergoing transoral endoscopic versus open thyroid surgery

“…Dysphagia after thyroid surgery is considered transient, mostly requiring reassurance but sometimes may require swallow therapy. However, swallowing dysfunction has been reported to negatively affect the swallowing related quality of life (SWAL‐QoL) after OTx 12–14 . The reason for changes in swallowing function could be injury to recurrent laryngeal nerves.…”

“…However, swallowing dysfunction has been reported to negatively affect the swallowing related quality of life (SWAL-QoL) after OTx. [12][13][14] The reason for changes in swallowing function could be injury to recurrent laryngeal nerves. However, dysphagia has been reported without the injury to these nerves and possible mechanisms suggested are surgical trauma, localized neck pain, cricothyroid muscle dysfunction, intraoperative injury of the thin anastomosis branches connecting the inferior laryngeal nerve and the external branch of the superior laryngeal nerve and/or one of its anastomoses with the sympathetic cervical chain, psychological reaction to surgery, manipulation of the peri-thyroid muscles, as well as intubation, and healing.…”