Skip to main content
SpringerLink
Log in

Assessment of Swallowing Function Impairment in Patients with Benign Goiters and Impact of Thyroidectomy: A Case Control Study

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Swallowing-related quality of life (QoL) in patients with benign thyroid goiters is not much studied. The aim of this study was to assess swallowing function impairment in patients with benign goiters, compare it to a control population, and also find the impact of thyroidectomy and various factors on the outcome of swallowing function.

Methods

We performed a prospective case–control study from September 2009 to September 2011 which consisted of 124 patients who were to undergo primary thyroid surgery and 100 age- and sex-matched controls. A translated and validated modified swallowing quality-of-life (SWAL-QOL) questionnaire was used to assess patients’ perception of dysphagia. Presurgery scores of patients and controls and pre- and postsurgery scores (>6 months after surgery) of patients were compared.

Results

The mean age of males and females in the control and patient groups were 37.7 vs. 39.5 years and 37.4 vs. 39.8 years, respectively. Twelve patients (9.7%) complained of dysphasia at presentation. Sixty-three patients (50.8%) underwent total thyroidectomy and 61 (49.2%) had hemithyroidectomy at the time of initial evaluation, 75, 23.4, and 1.6% of patients were euthyroid, hyperthyroid, and hypothyroid, respectively. Presurgery scores of patients in all of the 11 domains of the SWAL-QOL were lower compared to those of controls. Comparing separately with the matched controls, females had significant differences in nine domains (except for sleep and fatigue) of the SWAL-QOL questionnaire but males did not. Postoperatively, both male and female patients showed significant improvement in the scores of all the domains. Female gender, hyperthyroidism, thyroid nodularity, retrosternal extension, procedure, and weight of the resected specimen were the factors associated with significant improvement in various domains.

Conclusion

Dysphagia seems to be an underestimated problem in patients with benign goiters. Uncomplicated thyroidectomy results in significant improvement in swallowing-related QoL irrespective of patient profile and extent of thyroidectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alfonso A, Christoudias G, Amaruddin Q, Herbsman H, Gardner B (1981) Tracheal or esophageal compression due to benign thyroid disease. Am J Surg 142(3):350–354

    Article  PubMed  CAS  Google Scholar 

  2. Shaha AR (1990) Surgery for benign thyroid disease causing tracheoesophageal compression. Otolaryngol Clin North Am 23:391–401

    PubMed  CAS  Google Scholar 

  3. Donangelo I, Braunstein GD (2011) Update on subclinical hyperthyroidism. Am Fam Physician 83(8):33–38

    Google Scholar 

  4. Parperis K, Dadu R, Hoq S, Argento V (2011) Thyrotoxic dysphagia in an 82-year-old male. Case Report Med 2011:929523

    PubMed  Google Scholar 

  5. Pereira JA, Girvent M, Sancho JJ, Parada C, Sitges-Serra A (2003) Prevalence of long-term upper aero-digestive symptoms after uncomplicated bilateral thyroidectomy. Surgery 133:318–322

    Article  PubMed  Google Scholar 

  6. Lombardi CP, Raffaelli M, D’Alatri L, Marchese MR, Rigante M, Paludetti G, Bellantone R (2006) Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuries. Surgery 140:1026–1032

    Article  PubMed  Google Scholar 

  7. Lombardi CP, Raffaelli M, D’Alatri L, De Crea C, Marchese MR, Maccora D, Paludetti G, Bellantone R (2008) Video-assisted thyroidectomy significantly reduces the risk of early post thyroidectomy voice and swallowing symptoms. World J Surg 32(5):693–700. doi:10.1007/s00268-007-9443-2

    Article  PubMed  Google Scholar 

  8. Greenblatt DY, Sippel R, Leverson G, Frydman J, Schaefer S, Chen H (2009) Thyroid resection improves perception of swallowing function in patients with thyroid disease. World J Surg 33(2):255–260. doi:10.1007/s00268-008-9837-9

    Article  PubMed  Google Scholar 

  9. McHorney CA, Robbins J, Lomax K, Rosenbek JC, Chignell K, Kramer AE, Bricker DE (2002) The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia 17(2):97–114

    Article  PubMed  Google Scholar 

  10. McHorney CA, Bricker DE, Robbins J, Kramer AE, Rosenbek JC, Chignell KA (2000) The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: II. Item reduction and preliminary scaling. Dysphagia 15(3):122–133

    PubMed  CAS  Google Scholar 

  11. McHorney CA, Martin-Harris B, Robbins J (2008) Clinical validity of the SWAL-QOL and SWAL-CARE outcome tools with respect to bolus flow measures. Dysphagia 21(3):141–148; erratum in. Dysphagia 23(4):461

    Article  Google Scholar 

  12. Skoretz SA, Flowers HL, Martino R (2010) The incidence of dysphagia following endotracheal intubation: a systematic review. Chest 137(3):665–673

    Article  PubMed  Google Scholar 

  13. Cull A, Sprangers M, Bjordal K, Aaronson N, West K, Bottomley A (2002) EORTC Quality of Life Group: Translation procedure, 2nd ed. February 2002. EORTC working document. Available from the EORTC QL unit. http://groups.eortc.be/qol/downloads/200202translation_manual.pdf

  14. Rohana A, Hisham AN (2009) Emergency thyroid surgery: a surgical challenge. Asian J Surg 32(2):81–84

    Article  PubMed  Google Scholar 

  15. Watt T, Groenvold M, Rasmussen AK, Bonnema SJ, Hegedüs L, Bjorner JB, Feldt-Rasmussen U (2006) Quality of life in patients with benign thyroid disorders. A review. Eur J Endocrinol 154(4):501–510

    Article  CAS  Google Scholar 

  16. Roe JW, Leslie P, Drinnan MJ (2007) Oropharyngeal dysphagia: the experience of patients with non-head and neck cancers receiving specialist palliative care. Palliat Med 21(7):567–574

    Article  PubMed  Google Scholar 

  17. Gharib H, Papini E, Paschke R (2008) Thyroid nodules: a review of current guidelines, practices, and prospects. Eur J Endocrinol 159(5):493–505

    Article  PubMed  CAS  Google Scholar 

  18. Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, Vitti P; AACE/AME/ETA Task Force on Thyroid Nodules (2010) American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. Endocrinol Invest 33(5S):51–56

    Google Scholar 

  19. Bhagat MC, Dhaliwal SS, Bonnema SJ, Hegedüs L, Walsh JP (2003) Differences between endocrine surgeons and endocrinologists in the management of non-toxic multinodular goitre. Br J Surg 90:1103–1112

    Article  PubMed  CAS  Google Scholar 

  20. Schmitz-Winnenthal FH, Schimmack S, Lawrence B, Maier U, Heidmann M, Buchler MW, von Frankenberg M (2011) Quality of life is not influenced by the extent of surgery in patients with benign goiter. Langenbecks Arch Surg 396(8):1157–1163

    Article  PubMed  Google Scholar 

  21. Agarwal G, Aggarwal V (2008) Is total thyroidectomy the surgical procedure of choice for benign multinodular goiter? World J Surg 32:1313–1324. doi:10.1007/s00268-008-9579-8

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank the translators Dr. Subash Pandora and Dr. (Mrs.).Meenakshi Pawha for helping in reverse translation of the questionnaire. We acknowledge the contribution of Mr. M. S. Siddiqui in typing the Hindi version of the questionnaire. We also appreciate the contribution of the relatives and family members of the residents, hospital staff, and our patients for spending their valuable time in filling out the research questionnaire for validation and conduction of the current study.

Author information

Authors and Affiliations

  1. Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India

    Mayilvaganan Sabaretnam, Anjali Mishra, Gyan Chand, Gaurav Agarwal, Amit Agarwal, Ashok Kumar Verma & Saroj Kanta Mishra

Authors
  1. Mayilvaganan Sabaretnam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anjali Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gyan Chand
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gaurav Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amit Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ashok Kumar Verma
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Saroj Kanta Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anjali Mishra.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sabaretnam, M., Mishra, A., Chand, G. et al. Assessment of Swallowing Function Impairment in Patients with Benign Goiters and Impact of Thyroidectomy: A Case Control Study. World J Surg 36, 1293–1299 (2012). https://doi.org/10.1007/s00268-012-1562-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-012-1562-8

Keywords

Search

Navigation