Prevalence of upper aerodigestive symptoms in patients who underwent thyroidectomy with and without the use of intraoperative laryngeal nerve monitoring.
BACKGROUND
Upper aerodigestive symptoms (UADS) have been reported by patients who have had thyroidectomies. This study evaluated the long-term prevalence of UADS after thyroidectomy in patients who did and who did not have intraoperative neuromonitoring (IONM).


METHODS
This was a cross-sectional study of patients with normal vocal fold mobility who had a thyroidectomy. It included patients who did and did not have this surgery with IONM. All patients answered a questionnaire regarding UADS occurring one or more years after thyroidectomy. The questionnaire dealt with UADS relating to voice and swallowing symptoms and sought to quantify their severity. The 208 patients who underwent thyroidectomy without IONM were designated the control group (CG). The 100 patients who underwent thyroidectomy with IONM were designated the neuromonitored group (NMG).


RESULTS
The proportion of patients in the CG who reported UADS was 45%; 25.9% of these patients reported voice symptoms, and 33.6% reported swallowing symptoms. The proportion of patients in the NMG who reported UADS was 39%; 27% of these patients reported voice symptoms, and 22% reported swallowing symptoms. Thus, patients in the CG had more swallowing symptoms and a greater severity of UADS-related symptoms than patients in the NMG.


CONCLUSIONS
In this study, IONM had a favorable effect in terms of decreasing the prevalence and severity of UADS occurring one year or more after thyroidectomy.
Department of Voice, Speech, and Swallowing Rehabilitation, A.C. Camargo Hospital, Sao Paulo, Brazil.
Isabel Cristina Medeiros
IC
Silva
Irene de Pedro
Ide P
Netto
Jose Guilherme
JG
Vartanian
Luiz Paulo
LP
Kowalski
Elisabete
E
Carrara-de Angelis
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007823:Laryngeal Nerves / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D015995:Prevalence; D061226:Recurrent Laryngeal Nerve Injuries / Q000453:epidemiology / Q000209:etiology*; D013965:Thyroidectomy / Q000009:adverse effects*; D014832:Voice Disorders / Q000453:epidemiology / Q000209:etiology*