title: Changes in swallowing-related quality of life after parathyroidectomy for hyperparathyroidism: a prospective cohort study.
abstract: OBJECTIVE
  To prospectively evaluate the impact of parathyroidectomy on swallowing-related quality of life using the Swallowing Quality Of Life (SWAL-QOL) validated outcomes assessment tool.
  
  
  BACKGROUND
  Many patients with primary hyperparathyroidism report nonspecific symptoms, such as fatigue, irritability, cognitive impairment, sleep disturbances, and dysphagia. To date, there have been no prospective studies evaluating swallowing function before and after parathyroid surgery.
  
  
  METHODS
  Patients undergoing parathyroidectomy from September 2007 to January 2009 completed the SWAL-QOL questionnaire before and one year after surgery. Data were collected on demographic and clinicopathologic variables. Comparisons were made to determine the effect of surgery on patients' perceptions of swallowing function.
  
  
  RESULTS
  Of 151 eligible patients, 102 (68%) completed the study. The mean patient age was 60 years, and 79% were female. A total of 73 patients (67%) had minimally invasive parathyroidectomies, whereas the remainder had bilateral explorations. In all, 83 patients (81%) had a parathyroid adenoma, 16 patients (16%) had hyperplasia, and 3 patients (3%) had a double adenoma on final pathologic interpretation. Mean preoperative SWAL-QOL scores were <90 for 4 of the 11 domains, indicating the perception of oropharyngeal dysphagia and diminished quality of life. Following parathyroidectomy, significant improvements were demonstrated in eight SWAL-QOL domains.
  
  
  CONCLUSIONS
  Many patients with parathyroid disease have the perception of abnormal swallowing function. In these patients with symptoms of dysphagia, parathyroid surgery leads to significant improvements in many aspects of swallowing-related quality of life measured by the SWAL-QOL instrument. This study represents the first use of a condition-specific instrument to assess swallowing-related quality of life for patients with parathyroid disease before and after parathyroid surgery.
authors: F.A.C.S., K3-705 Clinical Science Center, 600 Highland Avenue, Madison, Wisconsin 53792, USA.
authors: Scott N
authors: SN
authors: Pinchot
authors: Linda
authors: L
authors: Youngwirth
authors: Victoria
authors: V
authors: Rajamanickam
authors: Sarah
authors: S
authors: Schaefer
authors: Rebecca
authors: R
authors: Sippel
authors: Herbert
authors: H
authors: Chen
mesh_terms: D015331:Cohort Studies; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy / Q000009:adverse effects*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires