Abstract
BACKGROUND: Patients with thyroid disease frequently complain of dysphagia. To date, there have been no prospective studies evaluating swallowing function before and after thyroid surgery. We used the swallowing quality of life (SWAL-QOL) validated outcomes assessment tool to measure changes in swallowing-related QOL in patients undergoing thyroid surgery. METHODS: Patients undergoing thyroid surgery from May 2002 to December 2004 completed the SWAL-QOL questionnaire before and one year after surgery. Data were collected on demographic and clinicopathologic variables, and comparisons were made to determine the effect of surgery on patients' perceptions of swallowing function. RESULTS: Of 146 eligible patients, 116 (79%) completed the study. The mean patient age was 49 years, and 81% were female. Sixty-four patients (55%) underwent total thyroidectomy and the remainder received thyroid lobectomy. Thirty patients (26%) had thyroid cancer. The most frequent benign thyroid conditions were multinodular goiter (28%) and Hashimoto's thyroiditis (27%). Mean preoperative SWAL-QOL scores were below 90 for nine of the eleven domains, indicating the perception of impaired swallowing and imperfect QOL. After surgery, significant improvements were seen in eight SWAL-QOL domains. Recurrent laryngeal nerve injury was associated with dramatic score decreases in multiple domains. CONCLUSIONS: In patients with thyroid disease, uncomplicated thyroidectomy leads to significant improvements in many aspects of patient-reported swallowing-related QOL measured by the SWAL-QOL instrument.