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Dysphagia

, Volume 30, Issue 5, pp 496–505 | Cite as

Videoendoscopic Evaluation of Swallowing After Thyroidectomy: 7 and 60 Days

  • Lica Arakawa-Sugueno
  • Alberto Rosseti Ferraz
  • Janaína Morandi
  • Dirce Maria Capobianco
  • Claudio Roberto Cernea
  • Maury Antônio Sampaio
  • Marco Aurélio Vamondes Kulcsar
  • César Augusto Simões
  • Lenine Garcia Brandão
Original Article

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.

Keywords

Deglutition Deglutition disorders Vocal cord paralysis Thyroidectomy Laryngoscopy 

Notes

Acknowledgments

Endoscopy Section and TecHealth Brasil for the scientific assistance (Dirce Maria Capobianco and Taís Moreira). Alexandro Duarte for the writing review. “Research on Research” for templates on scientific writing [31] and literature review [32].

Conflict of interest

None of the authors have any conflicts of interest to declare.

References

  1. 1.
    Grover G, Sadler GP, Mihai R. Morbidity after thyroid surgery: patient perspective. Laryngoscope. 2013;123(9):2319–23. doi: 10.1002/lary.23850.CrossRefPubMedGoogle Scholar
  2. 2.
    Finck C. Laryngeal dysfunction after thyroid surgery : diagnosis, evaluation and treatment. Acta Chir Belg. 2006;106:378–87.PubMedGoogle Scholar
  3. 3.
    Bicknell PG. Mild hypothyroidism and its effects on the larynx. J Laryngol Otol. 1973;87:123–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Pereira JA, Girvent M, Sancho JJ, Parada C, Sitges-Serra A. Prevalence of long-term upper aerodigestive symptoms after uncomplicated bilateral thyroidectomy. Surgery. 2003;133:318–22.CrossRefPubMedGoogle Scholar
  5. 5.
    Lombardi CP, Raffaelli M, D’alatri L, De Crea C, Marchese MR, Maccora D, Paludetti G, Bellantone R. Video-assisted thyroidectomy significantly reduces the risk of early postthyroidectomy voice and swallowing symptoms. World J Surg. 2008;32(5):693–700. doi: 10.1007/s00268-007-9443-2.CrossRefPubMedGoogle Scholar
  6. 6.
    Silva IC, de Netto I, Vartanian JG, Kowalski LP, Carrara-de Angelis E. Prevalence of upper aerodigestive symptoms in patients who underwent thyroidectomy with and without the use of intraoperative laryngeal nerve monitoring. Thyroid. 2012;22(8):814–9. doi: 10.1089/thy.2011.0118.CrossRefPubMedGoogle Scholar
  7. 7.
    Senise AT, Queija DS, Degani C, Corrêa LAC, Dedivitis RA, Lehn CN, Xavier C, Barros APB. Symptoms and signs of swallowing changes after thyroidectomy. Rev Bras Cir Cabeça Pescoço. 2009;38(2):67–71.Google Scholar
  8. 8.
    Scerrino G, Inviati A, Di GS, Paladino NC, Di Paola PV, Lo Re G, Almasio PL, Cupido F, Gulotta G, Bonventre S. Esophageal motility changes after thyroidectomy; possible associations with postoperative voice and swallowing disorders: preliminary results. Otolaryngol Head Neck Surg. 2013;148(6):926–32.CrossRefPubMedGoogle Scholar
  9. 9.
    Rosato L, Avenia N, Bernante P, De Palma M, Gulino G, Nasi PG, et al. Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. World J Surg. 2004;28(3):271–6.CrossRefPubMedGoogle Scholar
  10. 10.
    de Pedro NI, Fae A, Vartanian JG, Barros AP, Correia LM, Toledo RN, et al. Voice and vocal self-assessment after thyroidectomy. Head Neck. 2006;28(12):1106–14.CrossRefGoogle Scholar
  11. 11.
    Aluffi P, Policarpo M, Cherovac C, Olina M, Dosdegani R, Pia F. Post-thyroidectomy superior laryngeal nerve injury. Eur Arch Otorhinolaryngol. 2001;258(9):451–4.CrossRefPubMedGoogle Scholar
  12. 12.
    Stojadinovic A, Shaha AR, Orlikoff RF, Nissan A, Kornak MF, Singh B, et al. Prospectivefunctionalvoiceassessment in patientsundergoingthyroidsurgery. Ann Surg. 2002;236(6):823–32.PubMedCentralCrossRefPubMedGoogle Scholar
  13. 13.
    Lombardi CP, Raffaelli M, D’Alatri L, Marchese MR, Rigante M, Paludetti G, et al. Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuries. Surgery. 2006;140(6):1026–32 discussion 1032-4.CrossRefPubMedGoogle Scholar
  14. 14.
    GonçalvesFilho J, Kowalski LP. Surgical complications after thyroid surgery performed in a cancer hospital. Otolaryngol Head Neck Surg. 2005;132(3):490–4.CrossRefGoogle Scholar
  15. 15.
    Lee J, Kwon IS, Bae EH, Chung WY. 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. J Clin Endocrinol Metab. 2013;98(7):2701–8. doi: 10.1210/jc.2013-1583.CrossRefPubMedGoogle Scholar
  16. 16.
    Ryu JS, Lee JH, Kang JY, Kim MY, Shin DE, Shin DA. Evaluation of dysphagia after cervical surgery using laryngeal electromyography. Dysphagia. 2012;27(3):318–24. doi: 10.1007/s00455-011-9368-7.CrossRefPubMedGoogle Scholar
  17. 17.
    Lombardi CP, D’Alatri L, Marchese MR, Maccora D, Monaco ML, De Crea C, Raffaelli M. Prospective electromyographic evaluation of functional postthyroidectomy voice and swallowing symptoms. World J Surg. 2012;36(6):1354–60. doi: 10.1007/s00268-012-1481-8.CrossRefPubMedGoogle Scholar
  18. 18.
    Leder SB, Sasaki CT, Burrell MI. Fiberoptic endoscopic evaluation of dysphagia to identify silent aspiration. Dysphagia. 1998;13:19–21.CrossRefPubMedGoogle Scholar
  19. 19.
    Lombardi CP, Raffaelli M, De Crea C, D’Alatri L, Maccora D, Marchese MR, Paludetti G, Bellantone R. Long-term outcome of functional post-thyroidectomy voice and swallowing symptoms. Surgery. 2009;146(6):1174–81. doi: 10.1016/j.surg.2009.09.010.CrossRefPubMedGoogle Scholar
  20. 20.
    Jung SP, Kim SH, Bae SY, Lee SK, Kim S, Choi MY, Kim J, Kim M, Kil WH, Choe JH, Kim JH, Nam SJ, Kim JS. A new subfascial approach in open thyroidectomy: efficacy for postoperative voice, sensory, and swallowing symptoms. a randomized controlled study. Ann Surg Oncol. 2013;20(12):3869–76.CrossRefPubMedGoogle Scholar
  21. 21.
    Lee J, Chung WY. Robotic thyroidectomy and neck dissection: past, present, and future. Cancer J. 2013;19(2):151–61. doi: 10.1097/PPO.0b013e31828aab61.CrossRefPubMedGoogle Scholar
  22. 22.
    Murry T, Carrau RL. Functional tests of swallowing. In: Carrau RL, Murry T, editors. Comprehensive management of swallowing disorders. 2nd ed. San Diego: Singular Publishing Group; 1999. p. 75–9.Google Scholar
  23. 23.
    Santoro PP, Tsuji DH, Lorenzi MC, Ricci F. The role of videoendoscopic swallowing study in the quantitative evaluation of the oral and pharyngeal phases of deglutition in the elderly. Int Arch Otorhinolaryngol. 2003;7:181–7.Google Scholar
  24. 24.
    Yin S, Qiu WW, Stucker FJ, Batchelor BM. Critical evaluation of neurolaryngological disorders. Ann Otol Rhinol Laryngol. 2000;109:832–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Kamarunas EE, McCullough GH, Mennemeier M, Schluterman K. Effects of topical nasal anesthetic on fiberoptic endoscopic examination of swallowing with sensory testing (FEESST). Dysphagia. 2014;29:33–43.PubMedCentralCrossRefPubMedGoogle Scholar
  26. 26.
    Zollinger RM Jr, Zollinger RM. Atlas de Cirurgia. Rio de Janeiro: Guanabara-Koogan; 2003.Google Scholar
  27. 27.
    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. Clinical practice guideline: improving voice outcomes after thyroid surgery. Otolaryngol Head Neck. 2013;148(6 Suppl):S1–37. doi: 10.1177/0194599813487301.CrossRefGoogle Scholar
  28. 28.
    Tae K, Kim KY, Yun BR, Ji YB, Park CW, Kim DS, Kim TW. Functional voice and swallowing outcomes after robotic thyroidectomy by a gasless unilateral axillo-breast approach: comparison with open thyroidectomy. Surg Endosc. 2012;26(7):1871–7. doi: 10.1007/s00464-011-2116-0.CrossRefPubMedGoogle Scholar
  29. 29.
    Wasserman JM, Sundaram K, Alfonso AE, Rosenfeld RM, Har-El G. Determination of the function of the internal branch of the superior laryngeal nerve after thyroidectomy. Head Neck. 2008;30(1):21–7.CrossRefPubMedGoogle Scholar
  30. 30.
    Kark AE, Kissin MW, Auerbach R, Meikle M. Voice changes after thyroidectomy: role of the external laryngeal nerve. Br J Med. 1984;289:1412–5.CrossRefGoogle Scholar
  31. 31.
    Shah J, Shah A, Pietrobon R. Scientific writing of novice researchers: what difficulties and encouragements do they encounter? Acad Med. 2009;84:511–6.CrossRefPubMedGoogle Scholar
  32. 32.
    Pietrobon R, Guller U, Martins H, et al. A suite of web applications to streamline the interdisciplinary collaboration in secondary data analyses. BMC Med Res Methodol. 2004;4:29.PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Lica Arakawa-Sugueno
    • 1
  • Alberto Rosseti Ferraz
    • 1
  • Janaína Morandi
    • 1
  • Dirce Maria Capobianco
    • 1
  • Claudio Roberto Cernea
    • 1
  • Maury Antônio Sampaio
    • 1
  • Marco Aurélio Vamondes Kulcsar
    • 1
  • César Augusto Simões
    • 1
  • Lenine Garcia Brandão
    • 1
  1. 1.Department of Head and Neck SurgeryUniversity of São Paulo Medical SchoolSão PauloBrazil

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