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.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Academic research.
  
  
  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).
  
  
  CONCLUSIONS
  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.affiliation: Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy. gregorio.scerrino@tiscali.it
authors.forename: Gregorio
authors.initials: G
authors.lastname: Scerrino
authors.forename: Angela
authors.initials: A
authors.lastname: Inviati
authors.forename: Silvia
authors.initials: S
authors.lastname: Di Giovanni
authors.forename: Nunzia Cinzia
authors.initials: NC
authors.lastname: Paladino
authors.forename: Valentina
authors.initials: V
authors.lastname: Di Paola
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lo Re
authors.forename: Piero Luigi
authors.initials: PL
authors.lastname: Almasio
authors.forename: Francesco
authors.initials: F
authors.lastname: Cupido
authors.forename: Gaspare
authors.initials: G
authors.lastname: Gulotta
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Bonventre
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003680:Deglutition Disorders / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D015154:Esophageal Motility Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D013959:Thyroid Diseases / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods; D013997:Time Factors; D014832:Voice Disorders / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D055815:Young Adult
keywords: dysphagia; thyroidectomy; voice impairment