1Clinical Department for ENT and Head and Neck Surgery, Zagreb University Hospital Centre, 2Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Croatia, 3School of Medicine, Zagreb University, Croatia, 4Faculty of Education and Rehabilitation Sciences University of Zagreb, Croatia.
Acta Clin Croat. 2020 Jun;59(Suppl 1):38-49. doi: 10.20471/acc.2020.59.s1.05.
This study aims to provide insight into the etiology and frequency of swallowing complications that arise after thyroidectomy and to outline the available diagnostic procedures by revising the existing literature on this topic. We conducted a bibliographic search using the electronic database MEDLINE/PubMed to identify all relevant articles and 44 studies were included in the review out of a total of 218 published articles. Dysphagia after thyroid surgery is a common postoperative complication which, in the short- or long-term, significantly affects patient life quality. There is no standard diagnostic protocol for thyroidectomy-related swallowing impairment. Among the reviewed studies, 8 questionnaires and 12 instrumental diagnostic tools were used to identify swallowing difficulties related to thyroid surgery. The Swallowing Impairment Index (SIS-6) was the most-used questionnaire. Fiberoptic endoscopy is a standard diagnostic tool performed prior and after thyroid surgery, primarily to identify changes in vocal fold mobility. Although instrumental findings usually reveal non-specific alterations of swallowing; swallowing videofluoroscopy and esophageal manometry can be the most helpful tools in further management of thyroidectomy dysphagia. In patients with thyroidectomy-related swallowing difficulties and suspected laryngopharyngeal reflux, 24-hour MII-pH metry should be performed.
本研究旨在深入了解甲状腺切除术后吞咽并发症的病因和频率,并通过回顾该主题的现有文献,概述可用的诊断程序。我们使用电子数据库 MEDLINE/PubMed 进行了文献检索,以确定所有相关文章,在总共 218 篇已发表的文章中,有 44 篇研究被纳入综述。甲状腺手术后吞咽困难是一种常见的术后并发症,无论是在短期还是长期,都会显著影响患者的生活质量。目前没有针对甲状腺切除术后吞咽障碍的标准诊断方案。在回顾的研究中,有 8 份问卷和 12 种仪器诊断工具被用于识别与甲状腺手术相关的吞咽困难。吞咽障碍指数(SIS-6)是最常用的问卷。纤维喉镜检查是甲状腺手术前后的标准诊断工具,主要用于识别声带活动的变化。虽然仪器检查结果通常显示吞咽的非特异性改变;但吞咽荧光透视检查和食管测压检查可以在甲状腺切除术后吞咽困难的进一步管理中提供最有帮助的工具。对于甲状腺切除术后吞咽困难且疑似喉咽反流的患者,应进行 24 小时 MII-pH 监测。