Esophageal motility changes after thyroidectomy; possible associations with postoperative voice and swallowing disorders: preliminary results.

Francesco Cupido, Pier Luigi Almasio, Gaspare Gulotta, Valentina Di Paola, Sebastiano Bonventre, Angela Inviati, Giuseppe Lo Re, Nunzia Cinzia Paladino, Silvia Di Giovanni

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33 Citazioni (Scopus)

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.
Lingua originaleEnglish
pagine (da-a)926-932
Numero di pagine7
RivistaOTOLARYNGOLOGY-HEAD AND NECK SURGERY
Volume148
Stato di pubblicazionePublished - 2013

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Voice Disorders
Thyroidectomy
Deglutition Disorders
Deglutition
Pressure
Vocal Cord Paralysis
Thyroiditis
Lower Esophageal Sphincter
Acids
Proton Pump Inhibitors
Hyperthyroidism
Ataxia
Ambulatory Surgical Procedures
Thyroid Gland
Reference Values
Neck
Prospective Studies
Interviews
Research

All Science Journal Classification (ASJC) codes

  • Surgery
  • Otorhinolaryngology

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title = "Esophageal motility changes after thyroidectomy; possible associations with postoperative voice and swallowing disorders: preliminary results.",
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.",
author = "Francesco Cupido and Almasio, {Pier Luigi} and Gaspare Gulotta and {Di Paola}, Valentina and Sebastiano Bonventre and Angela Inviati and {Lo Re}, Giuseppe and Paladino, {Nunzia Cinzia} and {Di Giovanni}, Silvia",
year = "2013",
language = "English",
volume = "148",
pages = "926--932",
journal = "Otolaryngology - Head and Neck Surgery",
issn = "0194-5998",
publisher = "SAGE Publications Inc.",

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TY - JOUR

T1 - Esophageal motility changes after thyroidectomy; possible associations with postoperative voice and swallowing disorders: preliminary results.

AU - Cupido, Francesco

AU - Almasio, Pier Luigi

AU - Gulotta, Gaspare

AU - Di Paola, Valentina

AU - Bonventre, Sebastiano

AU - Inviati, Angela

AU - Lo Re, Giuseppe

AU - Paladino, Nunzia Cinzia

AU - Di Giovanni, Silvia

PY - 2013

Y1 - 2013

N2 - 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.

AB - 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.

UR - http://hdl.handle.net/10447/74798

UR - http://otojournal.org

M3 - Article

VL - 148

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EP - 932

JO - Otolaryngology - Head and Neck Surgery

JF - Otolaryngology - Head and Neck Surgery

SN - 0194-5998

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