Kazi Fatimah, Patil Shubhangi, Pathan Heena
Community Health Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2023 Feb 20;15(2):e35217. doi: 10.7759/cureus.35217. eCollection 2023 Feb.
Multinodular goiter is a condition in which the thyroid gland is swollen and has several distinct masses. A large multinodular goiter can lead to difficulty in swallowing and breathing. A large goiter hampers respiration and deglutition; therefore, a part of or the whole thyroid gland is removed. Total thyroidectomy is a surgical process which involves the removal of the whole thyroid gland. One of the adverse effects of a complete thyroidectomy is vocal cord paralysis. It occurs because of an injury to the recurrent laryngeal nerve. Vocal cord paralysis could be bilateral or unilateral. It is characterized by hoarseness of voice, breathing difficulties and voice pitch loss, and inability to talk loudly. This case report describes physiotherapy along with voice exercises in a 65-year-old female who suffered from unilateral vocal cord palsy following total thyroidectomy. The patient was successfully rehabilitated after four weeks, using a tailored physiotherapy program according to the difficulty faced by her. The rehabilitation exercises consisted of upper and lower limb mobility activities, breathing activities including thoracic expansion, and deep breathing exercises. Static hamstrings, static quadriceps exercise, heel slides and isometric exercise to neck muscles, and passive movements to the cervical spine were administered. Voice therapy exercises combined with breathing exercises were also administered.
结节性甲状腺肿是一种甲状腺肿大且有多个明显肿块的病症。巨大结节性甲状腺肿会导致吞咽和呼吸困难。巨大甲状腺肿会妨碍呼吸和吞咽，因此，会切除部分或整个甲状腺。全甲状腺切除术是一种切除整个甲状腺的外科手术。全甲状腺切除术的不良反应之一是声带麻痹。它是由于喉返神经受损所致。声带麻痹可为双侧或单侧。其特征为声音嘶哑、呼吸困难、音调丧失以及无法大声说话。本病例报告描述了一名65岁女性在全甲状腺切除术后发生单侧声带麻痹，接受物理治疗及嗓音训练的情况。根据该患者所面临的困难，为其制定了个性化的物理治疗方案，四周后患者成功康复。康复训练包括上下肢活动度训练、呼吸训练（包括胸廓扩张和深呼吸练习）。进行了静态腘绳肌、静态股四头肌练习、足跟滑动以及颈部肌肉等长运动，还有颈椎的被动运动。同时还进行了嗓音治疗练习并结合呼吸练习。
