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.
