title: Impact of thyroidectomy on the control of obstructive sleep apnea syndrome in patients with large goiters.
abstract: OBJECTIVE
  A large goiter can cause a series of compressive symptoms such as dyspnea and dysphagia, and previous case reports have indicated the coexistence of obstructive sleep apnea syndrome (OSAS) in these patients. The aim of this study was to evaluate the impact of thyroidectomy on the control of OSAS in patients with large goiters.
  
  
  METHODS
  Twenty-four patients with euthyroid goiters larger than 100 ml were consecutively selected. Of these, 17 (70.8%) presented OSAS and formed the research group. The protocol consisted of sleep questionnaires, physical examination, and polysomnography in baseline and after 3 months of surgery.
  
  
  RESULTS
  The average age of the patients was 58.3±9.9 years, and there were 5 (29.4%) males and 12 (70.6%) females. The significant findings in the postoperative period included a reduced neck circumference (p=0.041), reduced Epworth sleepiness score (p=0.025), decreased percentage of high-risk OSAS cases according to the Berlin questionnaire (p<0.001), and a tendency for a significant reduction in snoring (p=0.052). However, polysomnographic respiratory parameters showed no significant improvement after surgery.
  
  
  CONCLUSIONS
  Despite the high prevalence of OSAS in patients with large goiters and the improvement of OSAS symptoms, thyroidectomy showed no significant impact on the polysomnographic parameters.
authors.affiliation: Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço da Universidade Federal de São Paulo/UNIFESP, São Paulo, Brazil.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Haddad
authors.forename: Fernanda L
authors.initials: FL
authors.lastname: Martinho Haddad
authors.forename: Lia
authors.initials: L
authors.lastname: Bittencourt
authors.forename: Luis Carlos
authors.initials: LC
authors.lastname: Gregório
authors.forename: Sergio
authors.initials: S
authors.lastname: Tufik
authors.forename: Marcio
authors.initials: M
authors.lastname: Abrahão
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000150:complications* / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011183:Postoperative Complications / Q000175:diagnosis; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D013965:Thyroidectomy