Local neck symptoms before and after thyroidectomy: a possible correlation with reflux laryngopharyngitis

Objective Local symptoms in the neck such as swallowing, voice disorders and throat discomfort might be related to a goiter if present, but are also reported by patients suffering from reflux laryngopharyngitis. The aim of our study was to investigate the presence of reflux laryngopharyngitis in patients with nodular goiter before and after uncomplicated total thyroidectomy (TT) in order to evaluate if its presence could have any role in the origin of swallowing and voice alterations and throat discomfort. Study Design case series prospective study Setting hospitalized care in University Hospital Patients and Methods We consider twenty-five patients, affected by non-toxic nodular goiter and candidates for TT, who complained of local symptoms in the neck. All the patients were carefully interviewed, with emphasis on swallowing and voice disorders, throat discomfort and reflux-related symptoms and underwent a videolaryngoscopy (VLS) and a videofluoroscopic swallowing study (VFSS) before and three months after TT. Results Before thyroidectomy, reflux laryngopharyngitis-related alterations were present in 68% and in 50% at VLS and VFSS respectively. After thyroidectomy the swallowing and voice disorders persisted in 79% and 75% respectively, while throat discomfort persisted in 91%. Conclusions In patients with a non-toxic nodular goiter who complain of local neck symptoms, before surgery it is appropriate to investigate if a reflux laryngopharyngitis is present, VLS and VFSS could be indicated for this and if necessary an antireflux medical treatment should be administered