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Thyroid disease and compressive symptoms



Thyroid disease and compressive symptoms

Caroline A. Banks MD, Christopher M. Ayers BS, Joshua D. Hornig MD, Eric J. Lentsch MD, Terry A. Day MD, Shaun A. Nguyen MD, MA, M. Boyd Gillespie MD, MSc

The Laryngoscope,
122:1, December 06, 2011

Thyroid disease and compressive symptoms

Objectives/Hypothesis
Compressive symptoms are common in thyroid disease, but few studies have focused on the presence, associated factors, and etiology of compressive symptoms.


Study Design
Retrospective review.


Methods
Patients who underwent thyroidectomy from 2005 through 2009 were reviewed. The data included demographics, indication for surgery, compressive symptoms, complications, diagnosis, volume of thyroid gland, presence of inflammation, and follow-up.


Results
Three hundred thirty-three patients were identified. The mean age was 51 years, and 82% were female. Fifty-two percent (n = 172) of patients experienced compressive symptoms preoperatively, including dysphagia (n = 131) and shortness of breath (n = 83). Twenty-six percent (n = 86) of patients presented with voice changes, and 8% (n = 27) complained of odynophagia. Postoperatively, 25 patients (8%) continued to have compressive symptoms (P < .0001), and 10 patients (3%) developed new compressive symptoms. Compressive symptoms were present in 72% (n = 21) of patients with lymphocytic thyroiditis, 71% (n = 5) of patients with anaplastic thyroid cancer, and 60% (n = 92) of patients with goiter. The average volume of the gland in patients with compressive symptoms was 75.5 mL compared to 37.1 mL in asymptomatic patients (P < .0001). There was not a significant relationship between compressive symptoms and the presence of inflammation (P = .869).


Conclusions:
Patients with thyroid disease frequently present with compressive symptoms, and the majority of patients experience relief postoperatively. The volume of the thyroid gland is associated with compressive symptoms along with additional contributing factors.







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Prepared by: Dr. Houssam Al-Nahhas






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