eCollection 2023 Jan. Front Surg. Dysphagia continued to be reported in a significantly lower proportion of patients, even 1year after surgery. Considering the large number of individuals who may experience subjective dysphagia, preoperative counseling should include education and management of such symptoms. (PDF) Effects of Dysphagia Therapy on Swallowing Dysfunction after Analyzing the frequency of dysphagia according to different diagnoses, we found a significant risk of postoperative dysphagia in patients with Graves disease (chi-squared test=4.6) and carcinoma (chi-squared test=8.0). Many studies have discussed the effectiveness of speech therapy (e.g., voice therapy and dysphagia therapy) for improving dysphonia and dysphagia, but not specifically in patients who have received thyroidectomy. Total thyroidectomy. Swallowing disorders after thyroidectomy: What we know and where we are. https://doi.org/10.1097/00129689-200608000-00006, Yu ST, Chen WZ, Xu DB et al (2019) Minimally invasive video-assisted surgical management for parapharyngeal metastases from papillary thyroid carcinoma: a case series report. We're going to be doing a type of swallowing evaluation where we put a camera in your nose. If you have heartburn or GERD, try eating smaller meals and not eating right before bedtime. The systematic review of the literature resulted in 35 articles, which met the inclusion criteria and were analyzed regarding their type, sample, follow-up and results regarding post-thyroidectomy dysphagia in multiple follow-up times. https://www.uptodate.com/contents/search. https://doi.org/10.1007/s00268-013-2269-1, Chung EJ, Park MW, Cho JG et al (2015) A prospective 1-year comparative study of endoscopic thyroidectomy via a retroauricular approach versus conventional open thyroidectomy at a single institution. Aging and swallowing. Just long enough to take a look around at the anatomy, give you a couple of things to eat and drink, watch you swallow those and then we come out, okay. Chun BJ, Bae JS, Lee SH, Joo J, Kim ES, Sun DI. Introduction: Dysphagia and hoarseness are possible complications that can be observed in patients undergoing thyroidectomy or other neck surgery procedures. Your health care provider can then see changes in the shape of your esophagus and can assess the muscular activity. All patients underwent conventional surgery. JAMA. 2019 Feb;129(2):519-524. doi: 10.1002/lary.27297. The .gov means its official. The authors report no conflicts of interest in this work. Lombardi CP, Raffaelli M, DAlatri L, et al. Surg Laparosc Endosc Percutan Tech 28(6):366370. 2012 Dec;138(12):1161-6. doi: 10.1001/jamaoto.2013.803. 2014 Nov;28(6):799-808. doi: 10.1016/j.jvoice.2014.02.003. 2022 Dec 12;9:1064768. doi: 10.3389/fsurg.2022.1064768. A systematic review. Mayo Clinic does not endorse companies or products. A narrative review of current therapies in unilateral recurrent laryngeal nerve injury caused by thyroid surgery. -, World J Surg. Swallowing disorders after thyroidectomy: a systematic review and meta-analysis. https://doi.org/10.1002/hed.20648, Silva ICM, Netto IdP, Vartanian JG et al (2012) Prevalence of upper aerodigestive symptoms in patients who underwent thyroidectomy with and without the use of intraoperative laryngeal nerve monitoring. 2020 Jun;59(Suppl 1):38-49. doi: 10.20471/acc.2020.59.s1.05. Esophageal motility changes after thyroidectomy; possible associations with postoperative voice and swallowing disorders: preliminary results. Epub 2013 Aug 2. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. https://doi.org/10.1097/SLE.0000000000000582, Goswami S, Peipert BJ, Mongelli MN et al (2019) Clinical factors associated with worse quality-of-life scores in United States thyroid cancer survivors. Federal government websites often end in .gov or .mil. sharing sensitive information, make sure youre on a federal https://doi.org/10.1007/s00268-003-6903-1, Sasaki A, Nakajima J, Ikeda K et al (2008) Endoscopic thyroidectomy by the breast approach: a single institutions 9-year experience. However, only 8% of participants in this study (n = 2) qualified for a follow-up dysphagia evaluation, indicating that the majority of reported symptoms were subjective in nature. The authors did not receive any funding or support for the submitted work. Apart from that, dysphagia is common especially in elderly patients. I'm going to be helping out with the evaluation today. Considering long-term follow-up period, 12 studies reported an overall improvement of swallow symptoms. Isr Med Assoc J 8(2):106109, Wang C, Sun P, Li J et al (2016) Strategies of laparoscopic thyroidectomy for treatment of substernal goiter via areola approach. Sahli Z, Canner JK, Najjar O, Schneider EB, Prescott JD, Russell JO, Tufano RP, Zeiger MA, Mathur A. Laryngoscope. We're not in there very long. Eur Thyroid J 2(2):102109. Dysphagia following uncomplicated thyroidectomy: a systematic review Bethesda, MD 20894, Web Policies Frequency of swallowing disorder was similar in patients with sixth level dissection and patients with additionally lateral neck dissection (lateral neck dissection: 2 out of 6; sixth level dissection: 4 out of 12 patients). Price excludes VAT (USA) Swallowing disorders following thyroidectomy are common, even after surgery without confirmed complications. https://doi.org/10.1177/0003489417751472, Park KN, Mok JO, Chung CH et al (2015) Does postthyroidectomy syndrome really exist following thyroidectomy? The purpose of the current systematic review is to investigate the prevalence of dysphagia at various time points after thyroidectomy, at the whole spectrum of it (total/partial, open/endoscopic, for benign/malignant disease). doi: 10.7759/cureus.32836. Dysphagia. A feeding tube provides nutrients without the need to swallow. A randomized controlled study. Introduction: Dysphagia is frequently reported after thyroidectomy. Google Scholar, Araujo LF, Lopes LW, Silva POC et al (2017) Sensory symptoms in patients undergoing thyroidectomy. You may have some trouble chewing and swallowing after you go home. Which tests you need will depend on your situation. In 110 (50.2%) patients, dysphagia was reported only immediately postoperative and disappeared later spontaneously. The https:// ensures that you are connecting to the Your scar will be most visible for the first 1-2 months after surgery, improve Thyroidectomy - Mayo Clinic Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years. Figure 3 Frequency of dysphagia depending on diagnosis. Also at high risk of dysphagia are patients with Graves disease. doi: 10.1016/j.ijsu.2017.03.078. Surg Endosc 30(11):47214730. and transmitted securely. World J Surg 33(2):255260. World J Surg 38(2):378384. Of the 26 patients included, 69% were women (n = 18); mean (SD) age, 46.4 (14.1) years; mean (SD) tumor diameter 2.2 (1.4) cm. Types and timing of therapy for vocal fold paresis/paralysis after thyroidectomy: a systematic review and meta-analysis. World J Surg. If difficulty swallowing prevents you from eating and drinking enough and treatment doesn't allow you to swallow safely, your health care provider might recommend a feeding tube. Most of the symptoms resolved within 3 months of operation, but we found longer lasting dysphagia in almost 20% of patients. Fifty-three (21.3%) patients reported that the overall postoperative swallowing process was better or more trouble-free. No significant difference was noticed between open and endoscopic thyroid surgery at 2-3 months post-surgery. Accessed Sept. 21, 2021. UK VAT Group: GB 365 4626 36, Creative Commons Attribution - Non Commercial (unported, v3.0) License. Drafting: CV, AP. Surg Endosc. Codas 29(3):e20150294. Curr Opin Otolaryngol Head Neck Surg. Surgery 146(6):11741181. Accessed 1 Nov 2020, Alkan Z, Yigit O, Adatepe T et al (2014) Effect of anti-adhesive barrier use on laryngotracheal movement after total thyroidectomy: an electrophysiological study. Further, patients operated on for hyperparathyroidism were at significantly decreased risk of dysphagia (chi-squared test=4.2; Figure 3). Laryngoscope Investig Otolaryngol. Routine laryngoscopic examination was performed by an ear, nose, and throat specialist before and after surgery. Otolaryngol Head Neck Surg 148(6):926932. 2004 Jun;12(3):160-5. doi: 10.1097/01.moo.0000120302.58882.13. and transmitted securely. Schmitz-Winnenthal FH, Schimmack S, Lawrence B, et al. 2020 Jun;59(Suppl 1):38-49. doi: 10.20471/acc.2020.59.s1.05. Difficulty swallowing associated with GERD can be treated with prescription oral medications to reduce stomach acid. Scerrino G, Tudisca C, Bonventre S, Raspanti C, Picone D, Porrello C, Paladino NC, Vernuccio F, Cupido F, Cocorullo G, Lo Re G, Gulotta G. Int J Surg. Another aim was to review the literature on speech therapy for patients with recurrent laryngeal nerve paralysis after thyroidectomy. Scerrino G, Inviati A, Di Giovanni S, Paladino NC, Di Paola V, Lo Re G, Almasio PL, Cupido F, Gulotta G, Bonventre S. Otolaryngol Head Neck Surg. 2017 May 15;29(3):e20150294 Conflicts of Interest: The authors have no conflicts of interest to declare. Epub 2020 Nov 4. Rosato L, Avenia N, Bernante P, et al. The literature available at PubMed, SciELO and Cochrane Library databases was reviewed, according to PRISMA guidelines, using the terms dysphagia, swallowing disorder, deglutition disorder, thyroidectomy and thyroid surgery in the appropriate combinations. They may be due to irritation from the breathing tube inserted into the windpipe during surgery, or the result of nerve irritation caused by the procedure. Surg Endosc 24(12):31863194. There was . This site needs JavaScript to work properly. A quantitative synthesis of the results followed. Open access peer-reviewed scientific and medical journals. PubMed Central The swallowing disorders reported after thyroidectomy should be expected, but are not always detectable through objective methods. Galluzzi F, Garavello W (2019) Dysphagia following uncomplicated thyroidectomy: a systematic review. Dysphagia 34(2):161169. https://doi.org/10.1590/2317-1782/20172016294, Greenblatt DY, Sippel R, Leverson G et al (2009) Thyroid resection improves perception of swallowing function in patients with thyroid disease. An open thyroid biopsy - a rarely used operation where a nodule is excised directly; A hemi-thyroidectomy or thyroid lobectomy - where one lobe (one half) of the thyroid is removed; An isthmusectomy - removal of just the bridge of thyroid tissue between the two lobes; used specifically for small tumors that are located in the isthmus. Most patients complaining of long term swallowing disorders had bilateral thyroid resection with or without lymph node dissection. A systematic review was performed to identify studies concerning dysphagia post uncomplicated thyroid surgery. Do you ever vomit or bring up blood or black material? ESTIMation of the ABiLity of prophylactic central compartment neck Conclusions: Excluded from the evaluation were 27 patients with preoperatively existing (n=10) or postoperative (n=17) temporary or permanent paralysis of the recurrent nerve, since swallowing complaints and vocal changes are to be expected in these patients.2 Patients were questioned between 6 and 18 months postoperatively (median 14 months). Demographic-, disease-, and treatment-related variables for the study cohort are summarized in Table 2. The current literature available on MEDLINE database, concerning the swallowing disorders appearing after the thyroidectomy was reviewed. PubMed The options for medical treatment of euthyroid goiter are short-lived and are limited to thyroxine hormone suppression and radioactive iodine ablation. Design, setting, and participants: https://doi.org/10.4103/0022-3859.81867, Article eCollection 2022 Dec. Dysphagia following uncomplicated thyroidectomy: a systematic review. -. Swallowing disorders after thyroidectomy: What we know and - PubMed Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuries. https://doi.org/10.1258/002221505775010760, Ben Nun A, Soudack M, Best LA (2006) Retrosternal thyroid goiter: 15 years experience. Parathyroid surgery was performed without a routine four-gland exploration. Surgery might be needed to relieve swallowing problems caused by throat narrowing or blockages, including bony outgrowths, vocal cord paralysis, pharyngoesophageal diverticula, GERD and achalasia, or to treat esophageal cancer. Notes: The more invasive the operation was, the more patients suffered from dysphagia. Curr Opin Otolaryngol Head Neck Surg. I put a little green food coloring in the liquid and the puree that just allows us to see it better when the cameras in place. Clin Nurs Res 28(5):615635. Dysphagia after Thyroid Surgery Dysphagia 30(5):496505. Cervical esophageal stenosis secondary to intraoperative esophageal injury during thyroidectomy is much rarer and has not . One (0.5%) patient stated that up to 3 months postoperatively, swallowing problems had been successfully treated by logopedic therapy. If you have trouble swallowing, be sure to see a health care provider and follow his or her advice. JAMA Otolaryngol Head Neck Surg. The medication helps reduce the size of thyroid tissue. PMC Validating the SF-36 health survey questionnaire: new outcome measure for primary care. Eur Arch Otorhinolaryngol. Pragmat Obs Res 9:6368. Adverse events in thyroid surgery: observational study in three surgical units with high volume/year. Head Neck. Patient-Reported Dysphagia After Thyroidectomy: A Qualitative Study. https://doi.org/10.1159/000350854, Elzahaby IA, Fathi A, Abdelwahab K et al (2018) Endoscopic thyroidectomy using the unilateral axillo-breast approach versus the modified anterior chest wall approach: a prospective comparative study. One (0.5%) patient stated that up to 3 months postoperatively, swallowing problems had been successfully treated by logopedic therapy (answer d). Quality of life after thyroidectomy in patients with nontoxic nodular goiter: A prospective cohort study. The instrumental findings revealed non-specific alterations of swallowing. https://doi.org/10.1007/s00455-015-9628-z, Galluzzi F, Garavello W (2019) Dysphagia following uncomplicated thyroidectomy: a systematic review. Carrie: Your other hand. Google Scholar, Arakawa-Sugueno L, Ferraz AR, Morandi J et al (2015) Videoendoscopic evaluation of swallowing after thyroidectomy: 7 and 60 days. The opinions expressed in all articles published here are those of the specific author(s), and do not necessarily reflect the views of Dove Medical Press Ltd or any of its employees. I'm a speech pathologist. Patient-Reported Dysphagia After Thyroidectomy: A Qualitative Study. Speech therapy after thyroidectomy - PubMed However, our study also has several limitations. Eating soft foods for the first few days can be helpful. World J Surg. Scerrino G, Tudisca C, Bonventre S, Raspanti C, Picone D, Porrello C, Paladino NC, Vernuccio F, Cupido F, Cocorullo G, Lo Re G, Gulotta G. Int J Surg. Fifty-three (21.3%) patients reported that the overall postoperative swallowing process was better or more trouble-free (answer a; Table 1). Patient-Reported Dysphagia After Thyroidectomy - JAMA Examples include foods with sauces or gravy, cooked vegetables, and casseroles. 2023 Jan 11;8(1):140-149. doi: 10.1002/lio2.1009. Keywords: dysphagia, thyroidectomy, parathyroidectomy. Athanasia Printza. Several features of In the evaluation, 219 returns could be included. more. https://doi.org/10.1038/nrgastro.2015.199, Scerrino G, Tudisca C, Bonventre S et al (2017) Swallowing disorders after thyroidectomy: what we know and where we are. Would you like email updates of new search results? Clinical practice guideline: improving voice outcomes after thyroid surgery. The systematic review of the literature resulted in 35 articles, which met the inclusion criteria and were analyzed regarding their type, sample, follow-up and results regarding post-thyroidectomy dysphagia in multiple follow-up times. Eur Arch Otorhinolaryngol 279, 42134227 (2022). Dysphagia 35(2):253260. 2017 May;41 Suppl 1:S94-S102. https://doi.org/10.1210/jc.2013-1583, Lee J, Nah KY, Kim RM et al (2010) Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. In this retrospective cohort study, we sent questionnaires to 372 consecutive patients whose thyroid or parathyroid glands were operated on between May 2013 and October 2014 at Ulm University Hospital. You may also notice swelling, firmness, a pulling sensation, or even some trouble swallowing. 2019 Oct;276(10):2661-2671. doi: 10.1007/s00405-019-05599-y. Epub 2022 Apr 19. For example, are certain foods harder to swallow than others? One cause of these surgical outcomes is recurrent laryngeal nerve paralysis. Speech therapy; dysphagia; dysphagia therapy; dysphonia; intervention; recurrent laryngeal nerve paralysis; rehabilitation; swallowing therapy; thyroidectomy; vocal paralysis; voice therapy. CAS CAS The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Should Contralateral Nodules Be an Indication of Total or Completion Thyroidectomy for Patients With Unilateral Papillary Thyroid Carcinoma? Ann Surg Oncol. This study is retrospective, which means no preoperative swallowing disorders were raised and the duration of the postoperative survey was not uniform. 2005 Jun;29(6):780-4 Unilateral Vocal Fold Paralysis and Voice Therapy: Predictors of Long-Term Quality of Life. Idea for the study: AP, CV. https://doi.org/10.1007/s00464-011-2116-0, Kim WW, Jung JH, Lee J et al (2016) Comparison of the quality of life for thyroid cancer survivors who had open versus robotic thyroidectomy. https://doi.org/10.1007/s00268-013-1908-x, Koo CH, Sohn HM, Choi ES et al (2019) The effect of adjustment of endotracheal tube cuff pressure during scarless remote access endoscopic and robotic thyroidectomy on Laryngo-Pharyngeal complications: prospective randomized and controlled trial. Thyroidectomy: What It Is, Complications & Recovery - Cleveland Clinic Lombardi CP, Raffaelli M, De Crea C et al (2009) Long-term outcome of functional post-thyroidectomy voice and swallowing symptoms. The external branch of the superior laryngeal nerve is not exposed routinely. Park YM, Oh KH, Cho JG et al (2018) Changes in voice- and swallowing-related symptoms after thyroidectomy: one-year follow-up study. A two year prospective trial. Dysphagia after uncomplicated thyroidectomy is commonly reported and it includes a broad spectrum of swallowing complaints. Dysphagia after thyroidectomy can be best managed with application of conservative treatment, compensatory maneuvers and surgical treatment depending on the cause of dysphagia. Bulk reprints for the pharmaceutical industry. PLoS Med 6(7):e1000097. HHS Vulnerability Disclosure, Help Oncologist. 2022 Dec 22;14(12):e32836. 1992;305(6846):160164. National Library of Medicine 2006;140(6):10261034. Although many studies have investigated voice changes and assessment methods in thyroidectomy patients, few recent studies have investigated speech therapy after thyroidectomy. Speech therapy after thyroidectomy - Yu - Gland Surgery Swallowing disorders after thyroidectomy: a systematic review and meta-analysis. J Postgrad Med 57(2):120122. Many studies have discussed the effectiveness of speech therapy (e.g., voice therapy Speech therapy after thyroidectomy https://doi.org/10.1016/j.surg.2019.01.034, Hashemian M, Khorasani B, Tarameshlu M et al (2019) Effects of dysphagia therapy on swallowing dysfunction after total thyroidectomy. Testimonials The influence of the different therapy method or different diagnosis on dysphagia risk was examined by the chi-squared test. In: Higgins JPT, Churchill R, Chandler J, Cumpston MS (eds), Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0 (updated June 2017), Cochrane, 2017. www.training.cochrane.org/handbook. Fass R. Approach to the evaluation of dysphagia in adults. sharing sensitive information, make sure youre on a federal Further, we analyzed diagnosis and types of therapy to identify possible patients at risk. Thyroidectomy is the most commonly performed surgical procedure on endocrine glands and its effect on swallowing is common, following both complicated and uncomplicated surgery [1,2,3].Swallowing disorders after a recurrent laryngeal nerve injury are expected, because of the movement dysfunction caused on the larynx, and the damage of the superior laryngeal nerve can affect the sensory . Thyroid Surgery Recovery, Side Effects, and Complications - Verywell Health Am J Surg. Data analysis: CV, NT, AK, AP. Figure 2 Frequency of dysphagia depending on the operative therapy. Javascript is currently disabled in your browser. Importance: This site needs JavaScript to work properly. Surg Laparosc Endosc Percutan Tech 16(4):226231. Thyroidectomy-related Swallowing Difficulties: Review of the Literature. https://doi.org/10.1245/s10434-013-3163-7, Sinclair CF, Bumpous JM, Haugen BR et al (2016) Laryngeal examination in thyroid and parathyroid surgery: an American Head and Neck Society consensus statement. Web Design by Adhesion. doi: 10.7759/cureus.34078. eCollection 2022. The Role of Primary Repair of the Recurrent Laryngeal Nerve during Thyroid/Parathyroid Surgery in Vocal Outcomes-A Systematic Review. Cookies Unable to load your collection due to an error, Unable to load your delegates due to an error. Association Between Age and Patient-Reported Changes in Voice and Swallowing After Thyroidectomy. Ann Surg Oncol 22(9):30143021. National Institute on Deafness and Other Communication Disorders. We did not use a well-validated method or the swallowing quality of life validated outcomes assessment tool.2 Our questionnaire was not validated in the general population or in other studies. It goes in your nose about this far, just a little bit past that white line. The often used questionnaire Thyroid-Related Quality of Life Measure ThyPRO reports 13 multi-item scales, and dysphagia is only a sub-item of one of the 13 items (goiter symptoms). Clin Exp Otorhinolaryngol 8(1):7680. Arch Otolaryngol Head Neck Surg. So the different items we're going to be swallowing. G Chir. You may have follow-up appointments once or twice a year for several years after treatment ends. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Diagnostic methods failed to identify the physio pathological mechanism of swallow alteration leaving this condition still unclear. https://doi.org/10.1159/000508683, Ryu JH, Yom CK, Park DJ et al (2014) Prospective randomized controlled trial on the use of flexible reinforced laryngeal mask airway (LMA) during total thyroidectomy: effects on postoperative laryngopharyngeal symptoms. FOIA 2018 Apr 1;144(4):342-348. doi: 10.1001/jamaoto.2017.3378. An association between surgical insult following thyroid surgery and LPR needs further investigation. (2015) Videoendoscopic evaluation of swallowing after thyroidectomy: 7 and 60 days. The purpose of the current systematic review is to investigate the prevalence of dysphagia at various time points after thyroidectomy, at the whole spectrum of it (total/partial, open/endoscopic, for benign/malignant disease). Head Neck 30(1):2127. ani-Hadibegovi A, Hergei F, Babi E, Slipac J, Prstai R. Acta Clin Croat. Accessed Sept. 21, 2001. Multinodular goiter: Overview, causes, and treatment - Medical News Today . https://www.uptodate.com/contents/search. A prospective randomized controlled trial of the laryngeal mask airway versus the endotracheal intubation in the thyroid surgery: evaluation of postoperative voice, and laryngopharyngeal symptom. Of the 936 articles retrieved, 18 discussed "voice assessment and thyroidectomy", 3 discussed "voice therapy and thyroidectomy", and 11 discussed "surgical interventions for voice restoration after thyroidectomy". The type of surgical treatment depends on the cause of dysphagia. Antacids that you can get without a prescription also might help temporarily. https://doi.org/10.1007/s00268-008-9837-9, Sabaretnam M, Mishra A, Chand G et al (2012) Assessment of swallowing function impairment in patients with benign goiters and impact of thyroidectomy: a case control study. The good prognosis of DTC may carry more weight to the quality of life in considering the treatment strategy for DTC. Notes: Patients with Graves disease and carcinomas showed a significantly higher risk and patients with hyperparathyroidism a significantly lower risk of dysphagia. 2015;39(7):17131720. The most common complications after thyroidectomy are injuries associated with the recurrent laryngeal nerve and parathyroid gland. eCollection 2022. World J Surg. This is the camera we're going to use. A significant increase of swallowing impairment compared to baseline was recorded shortly after surgery. European Archives of Oto-Rhino-Laryngology Your arm or leg feels warm, tender, and painful. -, ANZ J Surg. Correlation of dysphagia with patients age, the specimen volume, and patients body mass index was calculated with Spearmans rank correlation coefficient. Hi, Addie. Our caring team of Mayo Clinic experts can help you with your dysphagia-related health concerns Comparison of swallowing disorder following gasless transaxillary endoscopic thyroidectomy versus conventional open thyroidectomy. Conclusion: Nearly 20% of patients reported postoperative dysphagia after uncomplicated thyroidectomy and parathyroidectomy, especially after major surgical intervention. All authors have contributed to the paper and have read and approved the final submitted version. The https:// ensures that you are connecting to the Only 3 studies discussed topics related to "swallowing function assessment/treatment and thyroidectomy". Common complaints of patients who have received thyroidectomy include dysphonia (voice dysfunction) and dysphagia (difficulty swallowing). 2013 Jan;83(1-2):15-21 2022 Sep;46(9):2212-2222. doi: 10.1007/s00268-022-06610-0. Traditional dysphagia therapy (TDT) has long been a routine rehabilitation. The site is secure. 2021 Aug 9;12:723631. doi: 10.3389/fendo.2021.723631. Langenbecks Arch Surg. Common complaints of patients who have received thyroidectomy include dysphonia (voice dysfunction) and dysphagia (difficulty swallowing).
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