Swallowing disorders after thyroidectomy: What we know and where we are. A systematic review

Abstract

Introduction Dysphagia and hoarseness are possible complications that can be observed in patients undergoing thyroidectomy or other neck surgery procedures. These complaints are usually related to superior and inferior laryngeal nerves dysfunction, but these can appear even after uncomplicated surgical procedure. Methods We reviewed the current literature available on MEDLINE database, concerning the swallowing disorders appearing after the thyroidectomy. The articles included in the review reported pathophysiology and diagnostic concerns. Results Twenty articles were selected for inclusion in the review. Depends on the possible causes of the difficulty swallowing (related to nerve damage or appearing after uncomplicated thyroidectomy), different types of diagnostic procedures could be used to study patient discomfort, as well as intraoperative nerve monitoring, fiber optic laryngoscopy, endoscopy, pH monitoring, esophageal manometry and videofluorography. Among all these procedures, videofluorography is considered the gold standard to evaluate the entire swallowing process, since that allows a real-time study of all the three phases of swallowing: oral phase, pharyngeal phase and esophageal phase. Conclusion The diagnostic procedures described can help to identify the mechanisms involved in swallowing disorders, with the aim to choose the best therapeutic option. More studies are needed for understanding the causes of the dysphagia appearing after thyroidectomy

Frequência combinada de queixas relacionadas à deglutição e voz antes da tireoidectomia

“…As expected, this group of patients had a higher number of symptoms in both functions compared to those whose self-assessment was positive. This result is in line with the literature, indicating that voice (1,11,(14)(15)(16)(18)(19)(20)(21) and swallowing (1,4,(13)(14)(15)(16)(17)(21)(22)(23) symptoms may be reported by patients referred for thyroidectomy. This is especially due to the compressive characteristics of thyroid disease, in addition to hormonal changes and impairment of laryngeal mobility or laryngotracheal complex (1,4) .…”

“…Stasis may also be referred to as a foreign body sensation in the throat and is cited in the literature as a frequent symptom in patients with thyroid disease (1,4,13,(15)(16)(17)21,22) . Therefore, it is assumed that in attempting to minimize the discomfort caused by the permanence of residues in the laryngopharynx, the patient develops throat clearing after swallowing, referred to in this study as the most frequent symptom among all related to swallowing.…”

“…Benign or malignant thyroid disorders affect hormone production and secretion (1) and may alter functional patterns of voice (1)(2)(3) and swallowing (1,3,4) . Such diseases can be treated by thyroidectomy, which consists of partial or total removal of the thyroid gland (1,5,6) .…”

“…However, voice and swallowing changes may be present even before thyroidectomy due to a possible hormonal disorder (1,2,4) . In addition, increased gland volume (1,11,12) and the presence of benign or malignant nodules (1,13,14) may cause compressive symptoms such as shortness of breath (1,13,14) , swallowing effort (1,4,14) , foreign body sensation in the throat (1,4,13,(15)(16)(17) , choking (17) , and odynophagia (1,4,13,17) , impacting the biomechanics of swallowing. Similarly, communication may be affected by vocal symptoms such as hoarseness, voice weakness, and monotonous voice (1,6,10,16) , as well as by physical symptoms such as throat clearing, pain and discomfort when speaking (18) .…”

The Effect of Cold Vapor Treated to Thyroidectomy Patients During Early Postoperative Period

“…Surgical interventions are used for many malignant and benign conditions of thyroid disease. Surgery and nursing care of thyroid gland, which is an important endocrine organ due to its functions, anatomic placement and neighborhood, requires a special knowledge and proficiency (1). Although thyroidectomy is one of the operations, which are frequently performed with a low mortality rate today, it may cause severe morbidity, bleeding, recurrent damage of neuronal and parathyroid glands and problems such as laryngeal edema (2,3).…”