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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2013

01-11-2013 | Endocrine Tumors

A New Subfascial Approach in Open Thyroidectomy: Efficacy for Postoperative Voice, Sensory, and Swallowing Symptoms. A Randomized Controlled Study

Authors: Seung Pil Jung, MD, PhD, Sung Hoon Kim, MD, PhD, Soo Youn Bae, MD, Se Kyung Lee, MD, Sangmin Kim, PhD, Min-Young Choi, MD, Jiyoung Kim, MD, Minkuk Kim, MD, Won Ho Kil, MD, PhD, Jun-Ho Choe, MD, PhD, Jung-Han Kim, MD, PhD, Seok Jin Nam, MD, PhD, Jee Soo Kim, MD, PhD

Published in: Annals of Surgical Oncology | Issue 12/2013

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Abstract

Background

After open thyroidectomy, patients usually complain of voice, sensory, and swallowing symptoms. We approached the thyroid via the subfascial method to reduce these symptoms and compared postthyroidectomy symptoms with the conventional subplatysmal method.

Methods

Eighty-six patients undergoing thyroidectomy were recruited and randomized into either a conventional subplatysmal approach group (subplatysmal, 42 patients) group or a subanterior fascia of strap muscle approach group (subfascial, 44 patients). Voice symptoms were assessed using the Voice Handicap Index questionnaire and acoustic voice analysis. Sensory alterations were evaluated by the light touch and pain touch methods. Swallowing symptoms were assessed using the Swallowing Impairment Score (SIS) questionnaire, barium swallowing time, and hyoid bone movement range. Each variable was measured preoperatively, and at 2 weeks and 3 months after thyroidectomy.

Results

In both groups, the subjective symptoms of voice, sensation, and swallowing were significantly worsened at 2 weeks after operation, but improved 3 months after operation. Patients in the subplatysmal group had worse SIS scores than patients in the subfascial group (p = 0.016) and delayed barium swallowing time 2 weeks after operation (p = 0.008 compared to preoperative level). In the cohort over 50 years of age, SIS score did not recover to preoperative levels in the subplatysmal group 3 months after operation (p = 0.005 compared to preoperative level).

Conclusions

The subfascial approach may be an effective method for reducing postthyroidectomy swallowing symptoms based on swallowing impairment score, especially in patients over 50 years of age.
Appendix
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Literature
1.
Ries LAG. Cancer survival among adults: U.S. SEER program, 1988–2001. Patient and tumor characteristics. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 2007.
2.
3.
Pereira JA, Girvent M, Sancho JJ, Parada C, Sitges-Serra A. Prevalence of long-term upper aerodigestive symptoms after uncomplicated bilateral thyroidectomy. Surgery. 2003;133:318–22.PubMedCrossRef
4.
Rosato L, Carlevato MT, De Toma G, Avenia N. Recurrent laryngeal nerve damage and phonetic modifications after total thyroidectomy: surgical malpractice only or predictable sequence? World J Surg. 2005;29:780–4.PubMedCrossRef
5.
Di Francia R, Papon X, Mercier P. [Anatomical study of the superficial cervical plexus: application to the prevention of the postoperative sensitive facial deficits]. Morphologie. 2011;95:3–9.PubMedCrossRef
6.
Peripheral nerves. In: Anatomy for anaesthetists. London: Blackwell Science; 2008. p 137–212.
7.
Jaeock K, Sung-Eun L, Sun-Young P, SeungHee C, Jae Nam C, Hong-Shik C. Validity and reliability of Korean-version of Voice Handicap Index and voice-related quality of life. Speech Sci. 2007;14:111–25.
8.
Lombardi CP, Raffaelli M, De Crea C, D’Alatri L, Maccora D, Marchese MR, et al. Long-term outcome of functional post-thyroidectomy voice and swallowing symptoms. Surgery. 2009;146:1174–81.PubMedCrossRef
9.
Lombardi CP, Raffaelli M, D’Alatri L, Marchese MR, Rigante M, Paludetti G, et al. Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuries. Surgery. 2006;140:1026–32.PubMedCrossRef
10.
Lombardi CP, Raffaelli M, D’alatri L, Crea C, Marchese MR, Maccora D, et al. Video-assisted thyroidectomy significantly reduces the risk of early postthyroidectomy voice and swallowing symptoms. World J Surg. 2008;32:693–700.PubMedCrossRef
11.
Kendall KA, McKenzie S, Leonard RJ, Goncalves MI, Walker A. Timing of events in normal swallowing: a videofluoroscopic study. Dysphagia. 2000;15:74–83.PubMed
12.
Aluffi P, Policarpo M, Cherovac C, Olina M, Dosdegani R, Pia F. Post-thyroidectomy superior laryngeal nerve injury. Eur Arch Otorhinolaryngol. 2001;258:451–4.PubMedCrossRef
13.
Diridollou S, Vabre V, Berson M, Vaillant L, Black D, Lagarde JM, et al. Skin ageing: changes of physical properties of human skin in vivo. Int J Cosmet Sci. 2001;23:353–62.PubMedCrossRef
14.
Debruyne F, Ostyn F, Delaere P, Wellens W. Acoustic analysis of the speaking voice after thyroidectomy. J Voice. 1997;11:479–82.PubMedCrossRef
15.
Hong SI, Kim PJ, Seung KB, Kwon JH, Beak JY, Yeo CD, et al. Percutaneous transluminal coronary angioplasty for coronary artery stenosis in a young patient with long term Kawasaki disease. Korean J Intern Med. 2005;20:187–90.PubMedCrossRef
16.
Akazaki S, Nakagawa H, Kazama H, Osanai O, Kawai M, Takema Y, et al. Age-related changes in skin wrinkles assessed by a novel three-dimensional morphometric analysis. Br J Dermatol. 2002;147:689–95.PubMedCrossRef
17.
Takema Y, Yorimoto Y, Kawai M, Imokawa G. Age-related changes in the elastic properties and thickness of human facial skin. Br J Dermatol. 1994;131:641–8.PubMedCrossRef
18.
Lauretani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A, et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol. 2003;95:1851–60.PubMed
19.
Pereira R, Cardoso BS, Itaborahy AS, Machado M. Analysis of handgrip strength from elderly women: a comparative study among age groups. Acta Med Port. 2011;24:521–6.PubMed
Metadata
Title
A New Subfascial Approach in Open Thyroidectomy: Efficacy for Postoperative Voice, Sensory, and Swallowing Symptoms. A Randomized Controlled Study
Authors
Seung Pil Jung, MD, PhD
Sung Hoon Kim, MD, PhD
Soo Youn Bae, MD
Se Kyung Lee, MD
Sangmin Kim, PhD
Min-Young Choi, MD
Jiyoung Kim, MD
Minkuk Kim, MD
Won Ho Kil, MD, PhD
Jun-Ho Choe, MD, PhD
Jung-Han Kim, MD, PhD
Seok Jin Nam, MD, PhD
Jee Soo Kim, MD, PhD
Publication date
01-11-2013
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 12/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3163-7

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