Most of the symptoms resolved within 3 months of operation, but we found longer lasting dysphagia in almost 20% of patients. Common complaints of patients who have received thyroidectomy include dysphonia (voice dysfunction) and dysphagia (difficulty swallowing). sharing sensitive information, make sure youre on a federal -, Codas. This work is published and licensed by Dove Medical Press Limited. https://doi.org/10.1097/SLE.0000000000000743, Lee J, Kwon IS, Bae EH et al (2013) Comparative analysis of oncological outcomes and quality of life after robotic versus conventional open thyroidectomy with modified radical neck dissection in patients with papillary thyroid carcinoma and lateral neck node metastases. https://doi.org/10.1007/s00464-002-8830-x, Article Panebianco M., et al. G Chir. We found no correlation between dysphagia and patients age or gender, the specimen volume, and patients body mass index. HHS Vulnerability Disclosure, Help Pak J Med Sci 30(5):11191122. Ann Otol Rhinol Laryngol 127(3):171177. Front Oncol 9:1226. https://doi.org/10.3389/fonc.2019.01226, Zhang Z (2014) Efficacy comparison of the anterior low small incision and the traditional incision for treatment of thyroid adenoma. This is a preview of subscription content, access via your institution. 2022 Jan;11(1):270-278. doi: 10.21037/gs-21-708. Indian J Otolaryngol Head Neck Surg 66(Suppl 1):7177. 2022 Sep;279(9):4213-4227. doi: 10.1007/s00405-022-07386-8. https://doi.org/10.1007/s00464-011-2116-0, Kim WW, Jung JH, Lee J et al (2016) Comparison of the quality of life for thyroid cancer survivors who had open versus robotic thyroidectomy. Our caring team of Mayo Clinic experts can help you with your dysphagia-related health concerns and transmitted securely. A systematic review. When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet. Compared to other studies concerning postoperative dysphagia, we included a large collective of patients and analyzed, in contrast to other studies, frequency of dysphagia according to patients diagnoses. World J Surg 33(2):255260. Carrie: That's the absolute worst part right there. You may have follow-up appointments once or twice a year for several years after treatment ends. World J Surg 37(4):786791. 2020 Jun;59(Suppl 1):38-49. doi: 10.20471/acc.2020.59.s1.05. We found that patients in this group are at high risk of dysphagia, since bilateral thyroid surgery is performed in these patients, often with lymph node dissection. Surg Endosc 26(7):18711877. Notes: The more invasive the operation was, the more patients suffered from dysphagia. government site. Furthermore, we asked the patients only about subjective symptoms of difficulties in swallowing. https://doi.org/10.1371/journal.pmed.1000097, Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. European Archives of Oto-Rhino-Laryngology Dysphagia , or swallowing problems, are common after thyroid surgery, though they usually don't last long, often resolving within two weeks. Eur Thyroid J 2(2):102109. Dysphagia continued to be reported in a significantly lower proportion of patients, even 1year after surgery. The more invasive the operation was, the more patients suffered from dysphagia. Greenblatt et al report a significant improvement in postoperative swallowing using the standardized SWAL-QOL questionnaire, designed to find out how swallowing problems affect quality of life.2 With the same questionnaire, Sabaretnam et al8 reported a significant improvement in quality of life in patients with benign goiters after thyroidectomy and Pinchot et al reported a significant improvement in quality of life in patients with parathyroid disease after thyroidectomy.9. Curr Opin Otolaryngol Head Neck Surg. Papanikolaou General Hospital, 57010, Thessaloniki, Greece, Chrysoula Vardaxi,Nikolaos Tsetsos&Alexandros Poutoglidis, Department of Food Science and Technology, International Hellenic University, Sindos Campus, 57400, Thessaloniki, Greece, 3rd Department of Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece, You can also search for this author in Epub 2013 Aug 2. https://doi.org/10.1007/s00268-015-3323-y, Hillenbrand A, Cammerer G, Dankesreiter L et al (2018) Postoperative swallowing disorder after thyroid and parathyroid resection. I put a little green food coloring in the liquid and the puree that just allows us to see it better when the cameras in place. Associations & Partners 2023 Jan 23;15(1):e34078. This site needs JavaScript to work properly. In 110 (50.2%) patients, dysphagia was reported only immediately postoperative and disappeared later spontaneously. 2012;17(10):12711276. Conclusion Dysphagia occurs in patients after thyroidectomy operations (regardless of larynx mobility alteration) and characterized by delayed triggering and stasis of food in the oro and . Curr Opin Otolaryngol Head Neck Surg. BMJ 372:n71. doi: 10.1016/j.jvoice.2021.02.030. Clipboard, Search History, and several other advanced features are temporarily unavailable. National Library of Medicine See this image and copyright information in PMC. Swallowing disorders after thyroidectomy: a systematic review and meta-analysis Swallowing disorders after thyroidectomy: a systematic review and meta-analysis . https://doi.org/10.1210/jc.2013-1583, Lee J, Nah KY, Kim RM et al (2010) Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Analyzing the frequency of dysphagia according to different diagnoses, we found a significant risk of postoperative dysphagia in patients with Graves disease and carcinoma. PMC National Institute on Deafness and Other Communication Disorders. Introduction: Dysphagia is frequently reported after thyroidectomy. The number of subjects varied from 12 to 254, the mean age from 39 to 54 years with an overall prevalence of females. doi: 10.1177/0194599813487301. This is the camera we're going to use. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Okay. For esophageal spasm, smooth muscle relaxants might help. Critical revision of the work: AP, ST, KS. 2009;33(2):255260. Thyroid. A thyroidectomy is the surgical removal of all (total thyroidectomy) or part (partial thyroidectomy) of your thyroid gland the butterfly-shaped organ in your neck. There's not much space between your nose and your throat, so it doesn't have to go in very far. A speech-language pathologist performing head positioning on a patient. Park JS, Frank E, Simental A, Perez HA, Park JJ, Filho PA, Murry T. J Voice. 2013;148(6):926932. MeSH Accessed 1 Nov 2020, Alkan Z, Yigit O, Adatepe T et al (2014) Effect of anti-adhesive barrier use on laryngotracheal movement after total thyroidectomy: an electrophysiological study. However the number of parathyroidectomy surgeries is very small (only 33 patients) and results can be influenced by the small number. Patient-Reported Dysphagia After Thyroidectomy: A Qualitative Study. Codas 29(3):e20150294. FOIA software development by maffey.com Two weeks after thyroidectomy, 80% of participants (n = 20) reported at least 1 swallowing-related symptom when prompted by the interview cards; during the open interview, 53% of participants (n = 14) volunteered discussion of swallowing-related symptoms unprompted. Neurological Sciences. All tests of significance were at the P<0.05 level. 2018 Apr 1;144(4):342-348. doi: 10.1001/jamaoto.2017.3378. Disclaimer. 2005 Jun;29(6):780-4 https://doi.org/10.1007/s00464-017-5929-7, Costa B, Rodrigues DSB, Magalhaes DDD et al (2020) Quantitative ultrasound assessment of hyoid bone displacement during swallowing following thyroidectomy. 2021 Apr;31(4):580-588. doi: 10.1089/thy.2020.0233. Hoarseness and Voice Problems Accessed Sept. 25, 2021. Have your symptoms been continuous or occasional? Summarizing, we have shown that patients frequently report postoperative dysphagia after uncomplicated thyroidectomy and parathyroidectomy, especially after major surgical intervention. In the also frequently used SF-36 questionnaire, dysphagia is not included.14 All these quality of life studies excluded patients with carcinoma. Accessed Sept. 24, 2021. Thyroidectomy is the most commonly performed surgical procedure on endocrine glands and its effect on swallowing is common, following both complicated and uncomplicated surgery [1,2,3].Swallowing disorders after a recurrent laryngeal nerve injury are expected, because of the movement dysfunction caused on the larynx, and the damage of the superior laryngeal nerve can affect the sensory . A randomized controlled study. Acta Anaesthesiol Scand 56(10):13141320. HHS Vulnerability Disclosure, Help Introduction: Swallowing disorder or dysphagia is a common complication after conventional total thyroidectomy. eCollection 2021. What websites do you recommend? Bukvi B, ivaljevi V, ipeti S, Dikli A, Tauanovi K, Paunovi I. Validation and cross-cultural adaptation of the questionnaire ThyPRO in thyroid patients in Serbia. In addition, choking decreased from 3 % to 2 %, dyspnea decreased from 9 % to 6 %, and cough decreased from 7 % to 5 %. The duration of the follow-up ranges from 1 month to 4 years. https://doi.org/10.1017/S0022215106002465, Maung KH, Hayworth D, Nix PA et al (2005) Thyroidectomy does not cause globus pattern symptoms. Greenblatt DY, Sippel R, Leverson G, Frydman J, Schaefer S, Chen H. Thyroid resection improves perception of swallowing function in patients with thyroid disease. We found that particularly after lymph node dissection and surgical treatment for Graves disease, postoperative dysphagia occurs. A randomized controlled study. Federal government websites often end in .gov or .mil. Additionally, some studies have addressed dysphagia after thyroidectomy, but few have discussed assessment and treatment of dysphagia after thyroidectomy. https://doi.org/10.1007/s00464-014-3658-8, Yoon JH, Park CH, Chung WY (2006) Gasless endoscopic thyroidectomy via an axillary approach: experience of 30 cases. https://doi.org/10.1001/jamaoto.2017.3378, Tomoda C, Sugino K, Tanaka T et al (2018) Globus symptoms in patients undergoing thyroidectomy: relationships with psychogenic factors, thyroid disease, and surgical procedure. https://doi.org/10.1111/coa.12913, Rosato L, Avenia N, Bernante P et al (2004) Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. This should not lead to underestimation of symptoms, since the patients quality of life is negatively affected by the symptomatology. 2017;39(11):22322240. World J Surg 36(6):12931299. World J Surg. Sousa F, Santos M, Azevedo S, Pinto A, Vaz Freitas S, Coutinho M, Almeida E Sousa C, Moreira da Silva . Cureus. Thyroidectomy is a largely performed procedure [].Dysphonia and dysphagia are common after thyroidectomy and can cause huge impact on the patient's quality of life [2, 3].Voice and swallowing complaints occur between 15 and 90 days after surgery [4-6].Though spontaneous complaints of swallowing are not common, it has been observed that when questioned about this specific aspect, the . Two weeks after thyroidectomy, 80% of participants (n = 20) reported at least 1 swallowing-related symptom when prompted by the interview cards; during the open interview, 53% of participants (n = 14) volunteered discussion of swallowing-related symptoms unprompted. Reasons for dysphagia could be, among others, postoperative scarring, modification in the vascular supply, or damage to tiny branches of the recurrent laryngeal nerve going to the cricopharyngeal muscle.6 The extent of the operative intervention seems to affect the probability of postoperative dysphagia. National Library of Medicine The authors have no conflicts of interest to declare, relevant to the content of this article. https://doi.org/10.1007/s00268-015-2995-7, Ryu JH, Han SS, Do SH et al (2013) Effect of adjusted cuff pressure of endotracheal tube during thyroidectomy on postoperative airway complications: prospective, randomized, and controlled trial. All rights reserved. Scerrino G, Inviati A, di Giovanni S, et al. 2013 Jun;148(6 Suppl):S1-37. We hypothesize that the rate of complete remission after thyroidectomy alone is not inferior to the rate of complete remission after thyroidectomy with PND by more than 5% at 1 year. Design, setting, and participants: Lembo AJ. Prevalence of long-term upper aerodigestive symptoms after uncomplicated bilateral thyroidectomy. Thyroid 23(1):6469. The swallowing disorders reported after thyroidectomy should be expected, but are not always detectable through objective methods. Vardaxi C, Tsetsos N, Koliastasi A, Poutoglidis A, Sapalidis K, Triaridis S, Printza A. Eur Arch Otorhinolaryngol. Dysphagia. The chi-squared test showed no significant relation between operation and dysphagia (thyroidectomy with/without lymph nodes: chi-squared test=3.2/2.7, subtotal resection/hemithyroidectomy: chi-squared test 0.3/2.1, and parathyroid resection: chi-squared test=3.7). An association between surgical insult following thyroid surgery and LPR needs further investigation. Video-assisted thyroidectomy significantly reduces the risk of early postthyroidectomy voice and swallowing symptoms. Keywords: dysphagia, thyroidectomy, parathyroidectomy. Dysphagia 34(2):161169. The good prognosis of DTC may carry more weight to the quality of life in considering the treatment strategy for DTC. Learn more about Institutional subscriptions, Lombardi CP, Raffaelli M, De Crea C et al (2009) Long-term outcome of functional post-thyroidectomy voice and swallowing symptoms. Patient-Reported Dysphagia After Thyroidectomy: A Qualitative Study | Endocrine Surgery | JAMA Otolaryngology-Head & Neck Surgery | JAMA Network This patient open-interview study attempts to characterize the effect of swallowing-related symptoms after thyroidectomy on patient quality of life and related [Skip to Navigation] Park YM, Oh KH, Cho JG et al (2018) Changes in voice- and swallowing-related symptoms after thyroidectomy: one-year follow-up study. Google Scholar, Araujo LF, Lopes LW, Silva POC et al (2017) Sensory symptoms in patients undergoing thyroidectomy. The authors did not receive any funding or support for the submitted work. Int J Surg 41(Suppl 1):S94S102. This injection will help any leftover thyroid tissue absorb the radioactive iodine. This site needs JavaScript to work properly. Analyzing the frequency of dysphagia according to different diagnoses, we found a significant risk of postoperative dysphagia in patients with Graves disease (chi-squared test=4.6) and carcinoma (chi-squared test=8.0). 2011;396(8):11571163. Thyroidectomy (surgical removal of all or part of the thyroid gland) may be performed for clinical indications that include malignancy, benign nodules or cysts, suspicious findings on fine needle aspiration biopsy, dysphagia from cervical esophageal compression, or dyspnea from airway compression. American College of Gastroenterology. Thyroidectomy-related Swallowing Difficulties: Review of the Literature. Carrie: Your other hand. In the early postoperative weeks after thyroidectomy, swallowing impairment is self-explanatory and is reported by most patients.6 Symptoms are often self-limiting, are not related to impaired nerve function and improve spontaneously. https://doi.org/10.1038/nrgastro.2015.199, Scerrino G, Tudisca C, Bonventre S et al (2017) Swallowing disorders after thyroidectomy: what we know and where we are. Clin Nurs Res 28(5):615635. Considering the large number of individuals who may experience subjective dysphagia, preoperative counseling should include education and management of such symptoms. J Clin Med. Epub 2019 Aug 14. World J Surg 38(2):378384. Am J Surg. The systematic review of the literature resulted in 35 articles, which met the inclusion criteria and were analyzed regarding their type, sample, follow-up and results regarding post-thyroidectomy dysphagia in multiple follow-up times. Dysphagia after uncomplicated thyroidectomy can arise early in the postoperative period resolving spontaneously in the first year. All surgical procedures were performed or supervised by an experienced endocrine surgeon. Did you first have trouble swallowing solids and then develop difficulty swallowing liquids? Dysphagia occurred depending on the operative therapy between 6.1% for parathyroid resection and 33% for total thyroidectomy with lymph node dissection. There was . Purpose: Surgery. Federal government websites often end in .gov or .mil. Chandrasekhar SS, Randolph GW, Seidman MD, Rosenfeld RM, Angelos P, Barkmeier-Kraemer J, Benninger MS, Blumin JH, Dennis G, Hanks J, Haymart MR, Kloos RT, Seals B, Schreibstein JM, Thomas MA, Waddington C, Warren B, Robertson PJ; American Academy of Otolaryngology-Head and Neck Surgery. Recurrent laryngeal nerve injury was diagnosed by means of laryngoscopic examination. Ann Surg Oncol. DISCHARGE INSTRUCTIONS: Seek care immediately if: You have sudden tingling or muscle cramps in your face, arm, or leg. 1992;305(6846):160164. This site needs JavaScript to work properly. https://doi.org/10.1177/0194599813482299, Sorensen JR (2018) The impact of surgery on quality of life, esophageal motility, and tracheal anatomy and airflow in patients with benign nodular goiter. Thyroid surgery is one of the most commonly performed endocrine surgical procedures, the risk of complications is high due to the anatomical structure and physiological function of the RLN.. Testimonials Adverse events in thyroid surgery: observational study in three surgical units with high volume/year. Examples include foods with sauces or gravy, cooked vegetables, and casseroles. Idea for the study: AP, CV. All right. Dan Med J 65(4):B5472, PubMed Dysphagia is a possible complication that can be observed in patients undergoing thyroidectomy, and can be related to superior and inferior laryngeal nerves dysfunction, but it usually appears after an uncomplicated surgical procedure. Recent advances in dysphagia management [version 1; peer review: 3 approved]. Accessed Sept. 21, 2021. Bookshelf The type of surgical treatment depends on the cause of dysphagia. An open thyroid biopsy - a rarely used operation where a nodule is excised directly; A hemi-thyroidectomy or thyroid lobectomy - where one lobe (one half) of the thyroid is removed; An isthmusectomy - removal of just the bridge of thyroid tissue between the two lobes; used specifically for small tumors that are located in the isthmus. In the evaluation, 219 returns could be included. Diagnostic methods failed to identify the physio pathological mechanism of swallow alteration leaving this condition still unclear. Surgery 166(1):6974. Would you like email updates of new search results? Table 1 Questionnaire sent to 358 patients at least 6 months postoperatively. We found no correlation between dysphagia and patients age, the specimen volume, and patients body mass index (Spearmans rank correlation coefficient = 0.1, each). eCollection 2021. After those tests, you'll see your doctor and get a thyrotropin alfa (Thyrogen ) injection (shot) to help you get ready for your treatment. Patients' Reaction to Diagnosis with Thyroid Cancer or an Indeterminate Thyroid Nodule. Isr Med Assoc J 8(2):106109, Wang C, Sun P, Li J et al (2016) Strategies of laparoscopic thyroidectomy for treatment of substernal goiter via areola approach. https://doi.org/10.2147/POR.S172059, Gumus T, Makay O, Eyigor S et al (2020) Objective analysis of swallowing and functional voice outcomes after thyroidectomy: a prospective cohort study. Introduction: Dysphagia and hoarseness are possible complications that can be observed in patients undergoing thyroidectomy or other neck surgery procedures. 2009;24(1):16. https://doi.org/10.3390/jcm8111787, Xu YJ, Wang SL, Ren Y et al (2012) A smaller endotracheal tube combined with intravenous lidocaine decreases post-operative sore throat - a randomized controlled trial. https://doi.org/10.1016/j.surg.2019.01.034, Hashemian M, Khorasani B, Tarameshlu M et al (2019) Effects of dysphagia therapy on swallowing dysfunction after total thyroidectomy. Drafting: CV, AP. X-ray with a contrast material (barium X-ray). bOne patient failed to complete the smoking field. Dysphagia is a typical symptom complained of preoperatively by patients with enlarged thyroid due to a direct compression of the swallowing organs.1 In these patients, uncomplicated thyroidectomy often leads to improvements in perceptions of swallowing function.2 But impaired swallowing and neck strangling also occur postoperatively. How can I best manage them together? Women with GD who are pregnant, nursing, or who have young children at home would benefit from a surgical consultation in an effort to . Accessibility Dysphagia. Prospective comparative analysis of open vs. endoscopic thyroidectomy. Your health care provider might also have you swallow solid food or a pill coated with barium to watch the muscles in your throat as you swallow or to look for blockages in your esophagus that the liquid barium solution might not identify. Good. PMC https://doi.org/10.1159/000508683, Ryu JH, Yom CK, Park DJ et al (2014) Prospective randomized controlled trial on the use of flexible reinforced laryngeal mask airway (LMA) during total thyroidectomy: effects on postoperative laryngopharyngeal symptoms. 2022 Dec 12;9:1064768. doi: 10.3389/fsurg.2022.1064768. Clinical practice guideline: improving voice outcomes after thyroid surgery. Most studies find that quality of life improves after thyroidectomy, although there are also some contradictory results.1013 Assessment of dysphagia is presumably insufficient in these studies, because the item dysphagia is underrepresented. Do you bring food back up (regurgitate) after swallowing it? BMJ. American Academy of Otolaryngology Head and Neck Surgery. 2006;140(6):10261034. Disclaimer. Chen PH, Golub JS, Hapner ER, Johns MM. In literature, we found no comparable study regarding Graves disease, although Cramon et al report that Graves disease causes severe disease-specific and generic health-related quality of life impairments, and deficits persist after treatment.15 One particular aspect of Graves disease could be inflammation, which can favor postoperative scarring. We'd like to do an assortment of consistencies, so we do a thin liquid, a puree, and then a solid consistency. Further, we analyzed diagnosis and types of therapy to identify possible patients at risk. Keywords: Do you ever vomit or bring up blood or black material? Dysphagia 35(2):253260. Mayo Clinic. Bookshelf The nicotine consumption and the subjective postoperative swallowing changes were examined via a questionnaire (Table 1). Further, there was no dependency of dysphagia on gender. this site will not function whilst javascript is disabled. PubMed Surg Endosc 30(4):15991606. Your health care provider will likely ask you for a description and history of your swallowing difficulties, perform a physical examination, and use various tests to find the cause of your swallowing problem. These are normal sensations. Thyroid. The https:// ensures that you are connecting to the If you have heartburn or GERD, try eating smaller meals and not eating right before bedtime. It goes in your nose about this far, just a little bit past that white line. PubMed Online ahead of print. https://doi.org/10.1007/s00268-012-1562-8, Burns P, Timon C (2007) Thyroid pathology and the globus symptom: are they related? Of 26 patients surveyed, 80% (n = 20) perceived dysphagia 2 weeks after thyroidectomy; 42% (n = 11) at 6 weeks; and 17% (n = 4) at 6 months after total thyroidectomy. Do you have difficulty swallowing solids, liquids or both? Head Neck. Dysphagia after uncomplicated thyroidectomy can arise early in the postoperative period resolving spontaneously in the first year. Dysphagia 30(5):496505. Lombardi et al report that the incidence and the severity of dysphagia is significantly reduced in patients who undergo video-assisted surgery compared with conventional surgery.16 In most cases, correlations for these swallowing disorders do not translate into objective findings and a discordance between objective deterioration and subjective symptoms is reported.6 Altered objective test results were reported by Scerrino et al. Head Neck 30(1):2127. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. Please enable it to take advantage of the complete set of features! Accessibility Arch Otolaryngol Head Neck Surg 135(4):342346. They may be due to irritation from the breathing tube inserted into the windpipe during surgery, or the result of nerve irritation caused by the procedure. Hi, Addie. Results This retrospective review included 45,539. sharing sensitive information, make sure youre on a federal https://doi.org/10.1111/j.1399-6576.2012.02768.x, Exarchos ST, Lachanas VA, Tsiouvaka S et al (2016) The impact of perioperative dexamethasone on swallowing impairment score after thyroidectomy: a retrospective study of 118 total thyroidectomies. Pragmat Obs Res 9:6368. official website and that any information you provide is encrypted Vardaxi C, Tsetsos N, Koliastasi A, Poutoglidis A, Sapalidis K, Triaridis S, Printza A. Eur Arch Otorhinolaryngol. This often increases over the first 1-2 weeks and then begins to resolve over 6-8 weeks. https://doi.org/10.1177/000348940411300914, Nouraei SAR, Allen J, Kaddour H et al (2017) 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. The purpose of the current systematic review is to investigate the prevalence of dysphagia at various time points after thyroidectomy, at the whole spectrum of it (total/partial, open/endoscopic, for benign/malignant disease).
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