title: Long-term esophageal motility changes after thyroidectomy: associations with aerodigestive disorders.
abstract: BACKGROUND
  Patients undergoing thyroidectomy often complain aerodigestive disorders. In a previous study we showed the associations between voice impairment and proximal acid reflux, swallowing impairment and Upper Esophageal Sphyncter (UES) incoordination and the decrease in UES pressure in thirty-six patients observed before and soon afterwards uncomplicated thyroidectomy. This study investigated the state of post-thyroidectomy esophageal motility changes and its associations with these disorders after 18-24 months.
  
  
  METHODS
  The thirty-six patients prospectively recruited according to selection criteria (thyroid volume ≤60 ml, benign disease, age 18-65 years, previous neck surgery, thyroiditis, pre- or postoperative vocal cord palsy) underwent voice (VIS) and swallowing (SIS) impairment scores, esophageal manometry and pH monitoring once again.
  
  
  RESULTS
  After 18-24 months, both VIS and SIS recovered (respectively: p=0,022; p=0,0001); UES pressure increased (p=0,0001) nearing the preoperative values. The persistence of swallowing complaints were associated with the persistence of esophageal incoordination (p=0,03); the association between voice impairment and proximal acid reflux was confirmed (p<0,001).
  
  
  CONCLUSIONS
  Our study confirms that aerodigestive disorders after uncomplicated thyroidectomy, largely transient, are strictly connected with upper esophageal motility changes. In this viewpoint, the innervation of upper aerodigestive anatomical structures (larynx, pharynx, upper esophagus) and its variations should be focused.
authors.forename: G
authors.initials: G
authors.lastname: Scerrino
authors.forename: A
authors.initials: A
authors.lastname: Inviati
authors.forename: S
authors.initials: S
authors.lastname: Di Giovanni
authors.forename: N C
authors.initials: NC
authors.lastname: Paladino
authors.forename: S
authors.initials: S
authors.lastname: Di Giovanni
authors.forename: N C
authors.initials: NC
authors.lastname: Paladino
authors.forename: V
authors.initials: V
authors.lastname: Di Paola
authors.forename: C
authors.initials: C
authors.lastname: Raspanti
authors.forename: G I
authors.initials: GI
authors.lastname: Melfa
authors.forename: F
authors.initials: F
authors.lastname: Cupido
authors.forename: S
authors.initials: S
authors.lastname: Mazzola
authors.forename: C
authors.initials: C
authors.lastname: Porrello
authors.forename: S
authors.initials: S
authors.lastname: Bonventre
authors.forename: G
authors.initials: G
authors.lastname: Gullotta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology*; D015154:Esophageal Motility Disorders / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013965:Thyroidectomy / Q000009:adverse effects*; D013997:Time Factors; D014832:Voice Disorders / Q000209:etiology*