Rodriguez Alexandra, Hans Stéphane, Lechien Jérôme R
Department of Otolaryngology-Head & Neck Surgery CHU Saint-Pierre (CHU de Bruxelles) Brussels Belgium.
Department of Otolaryngology-Head & Neck Surgery, Foch Hospital School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University) Paris France.
Laryngoscope Investig Otolaryngol. 2023 Jan 11;8(1):140-149. doi: 10.1002/lio2.1009. eCollection 2023 Feb.
Postthyroidectomy voice and swallowing symptoms (PVSS) may occur even in absence of laryngeal nerve injuries, which remains poorly understood. The objective of this review was to investigate the occurrence of PVSS and the potential etiological role of laryngopharyngeal reflux (LPR).
Scoping review.
Three investigators search PubMed, Cochrane Library, and Scopus databases for studies investigating the relationship between reflux and PVSS. The authors adhered to PRISMA statements and the following outcomes were investigated: age, gender, thyroid features, reflux diagnosis, association outcomes, and treatment outcomes. Based on the study findings and bias analysis, authors proposed recommendations for future studies.
Eleven studies met our inclusion criteria, accounting for 3829 patients (2964 females). Postthyroidectomy swallowing and voice disorders were found in 5.5%-64%; and 16%-42% of patients, respectively. Prospectively, some results suggested an improvement of swallowing/voice disorders postthyroidectomy, whereas others did not observe significant changes. The prevalence of reflux ranged from 16.6% to 25% of subjects who benefited from thyroidectomy. There was an important heterogeneity between studies regarding the profile of included patients, the PVSS outcomes used, the delay of PVSS assessment and reflux diagnosis, making difficult the study comparison. Some recommendations were provided to guide future studies, especially about the reflux diagnosis approach and clinical outcomes.
The potential etiological role of LPR in PVSS is not demonstrated. Future studies are needed to demonstrate an increase of pharyngeal reflux events with objective findings from prethyroidectomy to postthyroidectomy.
3a.
即使在没有喉返神经损伤的情况下，甲状腺切除术后也可能出现嗓音和吞咽症状（PVSS），对此目前仍知之甚少。本综述的目的是调查PVSS的发生率以及喉咽反流（LPR）的潜在病因学作用。
范围综述。
三名研究人员检索了PubMed、Cochrane图书馆和Scopus数据库，以查找研究反流与PVSS之间关系的研究。作者遵循PRISMA声明，并对以下结果进行了调查：年龄、性别、甲状腺特征、反流诊断、关联结果和治疗结果。基于研究结果和偏倚分析，作者提出了对未来研究的建议。
11项研究符合我们的纳入标准，涉及3829例患者（2964例女性）。甲状腺切除术后吞咽和嗓音障碍的发生率分别为5.5%-64%和16%-42%。前瞻性研究中，一些结果表明甲状腺切除术后吞咽/嗓音障碍有所改善，而另一些结果则未观察到显著变化。在接受甲状腺切除术的患者中，反流的发生率在16.6%至25%之间。在纳入患者的特征、所使用的PVSS结果、PVSS评估和反流诊断的延迟方面，各研究之间存在重要的异质性，这使得研究比较变得困难。提供了一些建议以指导未来的研究，特别是关于反流诊断方法和临床结果的研究。
LPR在PVSS中的潜在病因学作用尚未得到证实。需要进一步的研究来证明从甲状腺切除术前到术后，咽反流事件的客观结果有所增加。
3a。
