• Gregorio Scerrino, Angela Inviati, Silvia Di Giovanni, Nunzia Cinzia Paladino, Valentina Di Paola, Giuseppe Lo Re, Piero Luigi Almasio, Francesco Cupido, Gaspare Gulotta, and Sebastiano Bonventre.
• Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy. gregorio.scerrino@tiscali.it
• Otolaryngol Head Neck Surg. 2013 Jun 1;148(6):926-32.

ObjectiveSwallowing and voice impairment are common after thyroidectomy. We evaluated short-term functional changes in esophageal motility in a series of patients who had undergone total thyroidectomy. Several studies have investigated these symptoms by means of interviews or questionnaires.Study DesignProspective study.SettingAcademic research.Materials And MethodsThirty-six consenting patients were prospectively recruited. Eligibility criteria were thyroid volume ≤ 60 mL, benign disease, and age between 18 and 65 years. Exclusion criteria were previous neck surgery, severe thyroiditis, hyperthyroidism, and pre- or postoperative vocal cord palsy. Voice impairment score, swallowing impairment score, lower esophageal sphincter pressure, esophageal motility, upper esophageal pressure, and coordination were evaluated preoperatively and 30 to 45 days after surgery.ResultsPostoperative swallowing impairment (appearance or worsening of dysphagia) was found in 20% of patients and voice impairment in more than 30%. Both preoperative and postoperative esophageal motility were similar. All patients showed an average decrease of 25% in upper esophageal pressure, although the pressure was within normal range. Swallowing alterations were associated with upper esophageal incoordination (P < .03), and proximal acid reflux was significantly associated with voice impairment (P < .02).ConclusionAfter uncomplicated thyroidectomy, decreased upper esophageal pressure may explain both pharyngeal (dysphagia) and laryngeal (vocal impairment) exposure to acid. In the future, proton pump inhibitor therapy protocols should be evaluated.

41 keywords...

hide…