Swallowing Problems after Thyroidectomy

Abstract

Dysphagia is the medical term that is used to describe the difficulty of swallowing and the feeling of difficulty in passage of solids or semisolids or liquids from the mouth to the stomach. Objectives: The aim of this work is to evaluate swallowing after different types of thyroidectomy operations. Subjects and Methods: This study is a prospective, randomized trial on evaluation of swallowing after different types of thyroidectomy operations. This thesis study was conducted on 100 patients underwent different types of thyroidectomy operations, recruited from otorhinolaryngology and general surgery outpatient clinic Ain Shams university hospital from April 2018 to September 2019. An informed consent was obtained from each patient or their legal guardians before enrolment in the study. Each patient assessed by A EAT-10 Questionnaire and FEES(functional endoscopic evaluation of swallowing) both (pre-operative, early post-operative(EPO) and late post-operative(LPO). Results: The study include 100 patient and mean age of study cases was 37.4 ±10.1; females represented 94% of cases. Total thyroidectomy was performed in 94% of cases. Among our cases, we found that Dysphagia was scored 0% at pre-operative questionnaire, 82% at early post-operative questionnaire and 36% at late post-operative questionnaire. Two groups were compared by FEES: Group I with normal vocal fold mobility(NVFM) and Group II with abnormal vocal fold mobility(AVFM) (unilateral fixed vocal fold). Group I included 89 patients, Forty two percent of them had early Dysphagia, while only 22% of them had late dysphagia. As regard swallowing; we found that early post-operative delayed triggering, early post-operative aspiration; early post-operative penetration and early post-operative residue were 12.4%, 0%, 0% and 42.7% respectively. While late post-operative examination revealed that there was improvement of 6 patients and the number of patients of this group became 95 who had normal vocal fold mobility.