Longitudinal Kinematic Evaluation of Pharyngeal Swallowing Impairment in Thyroidectomy Patients
The aim of this study was to assess pharyngeal swallowing impairments in thyroidectomy patients and to delineate the contributory kinematic components. Forty consecutive patients (mean age = 47.33 years) and fourteen age- and sex-matched heathy adult volunteers (mean age = 42.64 years) participated in this study. A videofluoroscopic swallowing study (VFSS) was performed 1 day prior to surgery, and at 1 week and 3 months post-surgery. VFSS images were evaluated using the Modified Barium Swallowing Impairment Profile (MBSImp). Kinematic and temporal aspects of swallowing were characterized by measurement of maximum hyoid and laryngeal excursion, pharyngeal transit duration, laryngeal response duration (LRD), and laryngeal closure duration at each three time-points. At 1 week post-surgery, only pharyngeal impairment was significantly deteriorated than pre-surgery (p = 0.001). However, at 3 months, a significant improvement was observed to pre-surgery level (p = 0.01). Post-surgery, maximum hyoid excursion was significantly reduced in patients compared controls (p = 0.001). Although the maximal distance of the hyoid and the laryngeal excursion was shorter than before surgery, laryngeal excursion at all three time-points was similar to that of controls. At all three time-points, LRD was significantly longer in patients than in controls (p = 0.01). Following thyroidectomy, pharyngeal aspects of swallowing as measured by the MBSImp and kinematic aspects of swallowing were reduced with incomplete recovery at 3 months. These exploratory data may guide decision regarding management of pharyngeal swallowing impairment with patients undergoing total thyroidectomy.
KeywordsThyroidectomy The modified barium swallowing impairment Deglutition Kinematic hyolaryngeal excursion Temporal measurement Deglutition disorders
The first author would like to thank CCC-SLP., Todd R Fix, Instructor of the Communication Disorders Clinic at UCF, for his support and help.
Compliance with Ethical Standards
Conflict of interest
The authors have no conflict of interest to disclose.
- 2.Korea Statistics (2018) 24 Carcinoma Incidence Report of the Korea (1999–2015). http://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117N_A00022&vw_cd=MT_ZTITLE&list_id=101_11744&seqNo=&lang_mode=ko&language=kor&obj_var_id=&itm_id=&conn_path=MT_ZTITLE.
- 4.Scerrino G, Inviati A, Di Giovanni S, Paladino NC, Di Paola V, 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. https://doi.org/10.1177/0194599813482299.CrossRefPubMedGoogle Scholar
- 6.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. https://doi.org/10.1245/s10434-013-3163-7.CrossRefPubMedGoogle Scholar
- 16.Jordan Hazelwood R, Armeson KE, Hill EG, Bonilha HS, Martin-Harris B. Identification of swallowing tasks from a modified barium swallow study that optimize the detection of physiological impairment. J Speech Lang Hear Res. 2017;60(7):1855–63. https://doi.org/10.1044/2017_jslhr-s-16-0117.CrossRefPubMedPubMedCentralGoogle Scholar