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Videoendoscopic Evaluation of Swallowing After Thyroidectomy: 7 and 60 Days

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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.

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References

  1. Grover G, Sadler GP, Mihai R. Morbidity after thyroid surgery: patient perspective. Laryngoscope. 2013;123(9):2319–23. doi:10.1002/lary.23850.

    Article  PubMed  Google Scholar 

  2. Finck C. Laryngeal dysfunction after thyroid surgery : diagnosis, evaluation and treatment. Acta Chir Belg. 2006;106:378–87.

    CAS  PubMed  Google Scholar 

  3. Bicknell PG. Mild hypothyroidism and its effects on the larynx. J Laryngol Otol. 1973;87:123–7.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. 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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed Central  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  14. GonçalvesFilho J, Kowalski LP. Surgical complications after thyroid surgery performed in a cancer hospital. Otolaryngol Head Neck Surg. 2005;132(3):490–4.

    Article  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  18. Leder SB, Sasaki CT, Burrell MI. Fiberoptic endoscopic evaluation of dysphagia to identify silent aspiration. Dysphagia. 1998;13:19–21.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. 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. Yin S, Qiu WW, Stucker FJ, Batchelor BM. Critical evaluation of neurolaryngological disorders. Ann Otol Rhinol Laryngol. 2000;109:832–8.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Zollinger RM Jr, Zollinger RM. Atlas de Cirurgia. Rio de Janeiro: Guanabara-Koogan; 2003.

    Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed Central  PubMed  Google Scholar 

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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].

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

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Authors and Affiliations

  1. Department of Head and Neck Surgery, University of São Paulo Medical School, Dr. Enéas de Carvalho Aguiar, 255, ICHC - floor 8th (8° andar), room 8174 (sala 8174), São Paulo, 05403-000, Brazil

    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

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  1. Lica Arakawa-Sugueno
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  2. Alberto Rosseti Ferraz
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Correspondence to Lica Arakawa-Sugueno.

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Arakawa-Sugueno, L., Ferraz, A.R., Morandi, J. et al. Videoendoscopic Evaluation of Swallowing After Thyroidectomy: 7 and 60 Days. Dysphagia 30, 496–505 (2015). https://doi.org/10.1007/s00455-015-9628-z

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  • DOI: https://doi.org/10.1007/s00455-015-9628-z

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