Neck complaints before and after uncomplicated thyroidectomy: prevalence, postoperative outcome and relationships with thyroid weight and reflux like symptoms
Open Access
- 6 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Endocrine
- Vol. 73 (1), 98-106
- https://doi.org/10.1007/s12020-020-02568-y
Abstract
Purpose The surgical thyroid disease includes upper aerodigestive complaints with not homogenous prevalence and specific features. The purpose was to analyze before and after total thyroidectomy (TT) the prevalence and severity of voice, swallowing, respiratory, and reflux airway symptoms in relation with thyroid weight. Methods A total of 98 consenting patients undergoing TT were enrolled. Preoperatively, 1 and 3 months after TT, patients underwent videolaryngoscopy, subjective evaluation of voice (VIS), swallowing (SIS and EAT-10), respiratory (mMRC), and reflux symptoms (RSI, Gerd-Q). The scores were analyzed based on thyroid weight (75 gr) and post-operative score gain was calculated from the score before TT and the follow-up examination. Results In total, 40/98 selected cases of uncomplicated TT completed the postoperative evaluation. Endoscopic signs suggestive of reflux disease were observed in 1/40 (2.5%) and 0/19 cases before and after TT respectively. The prevalence of cases with abnormal reflux symptom index decreased significantly after surgery (8/40 vs 1/40) (p < 0.05), similarly occurred for the Gerd-Q (4/40 vs 1/40) (p < 0.05). Three months after TT the voice, swallowing and respiratory scores were significantly lower than the preoperative ones (p < 0.05). The SIS correlated positively with EAT-10 and RSI. After 3 months the postoperative score gain of voice, swallowing, respiratory, and reflux symptoms (Gerd-Q) was statistically higher (p < 0.05) in the cases with heaviest gland. Conclusions The surgical thyroid disease is associated to mild aerodigestive preoperative compressive symptoms, that include respiratory abnormalities and reflux like symptoms, regardless of the gland weight. In absence of endoscopic signs of airway reflux the presence of reflux symptoms suggests an overlapping with thyroid neck complaints. The patients undergoing uncomplicated TT had improvement in compressive symptoms and the greatest improvement is seen in larger goiters.This publication has 26 references indexed in Scilit:
- Long-term outcome of functional post-thyroidectomy voice and swallowing symptomsSurgery, 2009
- Impact of thyroidectomy without laryngeal nerve injury on vocal quality characteristics: An objective multiparameter approachThe Laryngoscope, 2009
- Development of the GerdQ, a tool for the diagnosis and management of gastro‐oesophageal reflux disease in primary careAlimentary Pharmacology & Therapeutics, 2009
- Thyroid Resection Improves Perception of Swallowing Function in Patients with Thyroid DiseaseWorld Journal of Surgery, 2008
- The Functional Impact on Voice of Sternothyroid Muscle Division During ThyroidectomyAnnals of Surgical Oncology, 2008
- Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuriesSurgery, 2006
- Thyroid pathology and the globus symptom: are they related? A two year prospective trialThe Journal of Laryngology & Otology, 2006
- Voice changes after thyroidectomy without recurrent laryngeal nerve injuryJournal of the American College of Surgeons, 2004
- The Validity and Reliability of the Reflux Finding Score (RFS)The Laryngoscope, 2001
- Tracheal or esophageal compression due to benign thyroid diseaseThe American Journal of Surgery, 1981