1. Esophageal Motility Changes after Thyroidectomy; Possible Associations with Postoperative Voice and Swallowing Disorders: Preliminary Results
- Author
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Gaspare Gulotta, Piero Luigi Almasio, Angela Inviati, Francesco Cupido, Nunzia Cinzia Paladino, Sebastiano Bonventre, Giuseppe Lo Re, Gregorio Scerrino, Silvia Di Giovanni, Valentina Di Paola, Sterrino, G, Inviati A, Di Giovanni, S, Paladino, NC, Di Paola, V, Lo Re, G, Almasio, PL, Cupido, F, Gulotta, G, and Bonventre S
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Manometry ,medicine.medical_treatment ,Comorbidity ,Audiology ,Risk Assessment ,Severity of Illness Index ,Statistics, Nonparametric ,Cohort Studies ,Young Adult ,Age Distribution ,medicine ,Humans ,Esophageal Motility Disorders ,Prospective Studies ,Sex Distribution ,dysphagia, thyroidectomy, voice impairment ,Aged ,Voice impairment ,Settore MED/12 - Gastroenterologia ,Voice Disorders ,business.industry ,Incidence ,Swallowing Disorders ,Thyroidectomy ,Middle Aged ,Thyroid Diseases ,Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche ,Settore MED/18 - Chirurgia Generale ,Settore MED/31 - Otorinolaringoiatria ,Italy ,Otorhinolaryngology ,Anesthesia ,Female ,Surgery ,Deglutition Disorders ,business ,Esophageal motility ,Follow-Up Studies - Abstract
Objective Swallowing 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 Design Prospective study. Setting Academic research. Materials and Methods Thirty-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. Results Postoperative 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). Conclusion After 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.
- Published
- 2013