Evaluation of functional impact following thyroidectomy tends to be focused on voice quality. The aim of this study was to document early (seven days postoperatively) and late changes (60 days postop) in swallowing function after thyroidectomy. A preoperative naso-endoscopic evaluation was performed to classify patients into groups of either normal laryngeal mobility (NLM: n = 39) or abnormal laryngeal mobility (ALM: n = 15). A FEES assessment of swallowing was performed at seven and 60 days post surgery, to evaluate four swallowing parameters: premature spill of food; laryngeal penetration; aspiration; post swallow residue / retention.

Of the 54 patients included in this study, 87% with ALM and 44% with NLM demonstrated some dysphagia.

Laryngeal penetration and aspiration occurred more frequently (33%) in the ALM group, particularly for liquids. For both groups, the most notable problem was post swallow retention – thick liquids and paste being worse than thin liquids. While swallowing abnormalities were more common in the early phase, they were found to persist (particularly problems with residue / retention) into the late phase regardless of laryngeal mobility. The authors also highlight that for the ALM group – even patients who demonstrated recovery of laryngeal movement by the late phase, continued to demonstrate abnormalities in post swallow residue. They postulate that perhaps the surgical access approach / cervical manipulation may account for these findings – citing studies using robotic techniques that report less impact on swallowing to support their argument.

Videoendoscopic evaluation of swallowing after thyroidectomy: seven and 60 days.
Arakawa-Sugueno L, Ferraz AR, Morandi J, et al.
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Roganie Govender

University College London, Head & Neck Academic Centre, UK.

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