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.
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.
Authors: C Raspanti; C Porrello; G Augello; A Dafnomili; G Rotolo; A Randazzo; N Falco; T Fontana; R Tutino; G Gulotta Journal: G Chir Date: 2017 Jan-Feb
Authors: G Scerrino; A Inviati; S Di Giovanni; N C Paladino; S Di Giovanni; N C Paladino; V Di Paola; C Raspanti; G I Melfa; F Cupido; S Mazzola; C Porrello; S Bonventre; G Gullotta Journal: G Chir Date: 2017 Sep-Oct
Authors: G Melfa; C Porello; G Cocorullo; C Raspanti; G Rotolo; A Attard; R Gullo; S Bonventre; G Gulotta; G Scerrino Journal: G Chir Date: 2018 Jan-Feb
Authors: Brittany N Krekeler; Elizabeth Wendt; Cameron Macdonald; Jason Orne; David O Francis; Rebecca Sippel; Nadine P Connor Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-04-01 Impact factor: 6.223
Authors: G Cocorullo; G Scerrino; G Melfa; C Raspanti; G Rotolo; V Mannino; P Richiusa; D Cabibi; A G Giannone; C Porrello; G Gulotta Journal: G Chir Date: 2017 Sep-Oct