Videoendoscopic Evaluation of Swallowing After Thyroidectomy: 7 and 60 Days

Abstract

Deglutition complaints are frequent after thyroidectomy. The purpose of this study was to follow-up on patients with thyroidectomy indication to compare the videoendoscopic evaluation of swallowing on the seventh day (early postoperative, EPO) and on the 60th day after thyroidectomy, (late postoperative, LPO) and to compare patients that evolved with normal laryngeal mobility (NLM) and abnormal laryngeal mobility (ALM). Nasofibroscopic evaluation was performed preoperatively (PRE), on the EPO and LPO. Two groups were compared: ALM and NLM. The majority of people were women, age bracket 46-65, who underwent total thyroidectomy and with high frequency of carcinoma. 30 out of the 54 patients in the study had change in swallowing (55 %). Dysphagia occurred in 87 % (13/15) of patients with ALM in the EPO and remained in 67 % of them in the LPO. In the NLM group, dysphagia occurred in 44 % (17/39) in EPO and 25 % in LPO. There was a statistical difference between PRE and EPO, and PRE and LPO (P < 0,001). In the ALM group, liquid penetration and aspiration were identified in 33 % of the cases during EPO (P = 0,014); retention of food occurred in 87 % in EPO and in 60 % in LPO (P < 0,001). Dysphagia occurs in patients after thyroid surgery (regardless of larynx mobility alteration) and characterized by stasis of food in the oro and hypopharynx, which is also noticed in LPO, though more frequently in EPO.

Patient-Reported Dysphagia After Thyroidectomy

“…Swallowing symptoms and persistence of complaints reported in our study, including sensation of residue, painful swallowing, and difficulty swallowing, are consistent with previous studies of patients following thyroidectomy. 5,7,10,11,13 However, in contrast to previous studies, which used crosssectional or retrospective methods, ours was designed a priori to assess the longitudinal nature of dysphagia complaints. This study also allowed patients to describe what they were experiencing and the affect these symptoms had on quality of life in their own words.…”

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

“…The authors concluded that the correlation between laryngeal mobility and swallowing disorders was not proved. Another study [15] evaluated a group of patients that underwent thyroidectomy with a laryngeal nasofibroscopy performed in the early postoperative period and later. Moreover, the patients that evolved with normal laryngeal mobility and abnormal laryngeal mobility were compared each other.…”

Vocal palsy increases the risk of lower respiratory tract infection in low‐risk, low‐morbidity patients undergoing thyroidectomy for benign disease: A big data analysis

“…There are a wide range of surgical procedures that place normally functioning laryngeal nerves at risk of injury, which in turn places the patient at risk of post‐operative dysphonia, dysphagia, and less commonly, airway compromise . Thyroidectomy is the commonest of these procedures (Figure ).…”

“…[5][6][7][8][9] There are a wide range of surgical procedures that place normally functioning laryngeal nerves at risk of injury, which in turn places the patient at risk of post-operative dysphonia, dysphagia, and less commonly, airway compromise. 5,[10][11][12][13][14] Thyroidectomy is the commonest of these procedures (Figure 1). Post-surgical vocal palsy is a known risk factor for the development of acute hospitalacquired pneumonia following oesophageal and aortic surgery, 15,16 but little is known about any associations that may exist between post-thyroidectomy vocal palsy and long-term pneumonia risk.…”