Post-Thyroidectomy Syndrome

Hong, Ki Hwan

Abstract

Phonatory and swallowing symptoms after thyroidectomy are well-known implications of laryngeal nerve injuries. The laryngeal nerve injuries, superior and inferior, are major complication that results in changes both to voice quality and production of high-pitched sounds, which is of utmost importance for voice professionals. However, these functional and subjective voice and swallowing symptoms were often neglected by clinicians. Most voice and swallowing alterations after thyroidectomy are self limited and are not related to demonstrable impaired nerves function. Several causes have been supposed to interpret these symptoms. They have been attributed to arytenoid trauma after endotracheal intubation, surgical trauma, modification of the vascular supply of the larynx, local pain in the neck, cricothyroid dysfunction, strap muscle mal-function, laryngotracheal fixation with impairment of vertical movement, and psychologic reaction to the operation. Because of the impact of patient's perception on postoperative outcome in recent years, some groups have extensively investigated this functional post-thyroidectomy syndrome. All the published studies demonstrate that most patients who undergo thyroidectomy have at least some subjective vocal and/or swallowing complaints early after the opera-tion. Despite increasing interest, prospective data about the long-term outcomes of functional postthyroidectomy syndrome are lacking. This paper is to review the long-term trend and evolution of voice and swallowing symptoms after thyroidectomy in the absence of laryngeal nerve injury.