Thyroid disease and compressive symptoms

Authors

  • Caroline A. Banks MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
    • Department of Otolaryngology, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425
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  • Christopher M. Ayers BS,

    1. Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
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  • Joshua D. Hornig MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
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  • Eric J. Lentsch MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
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  • Terry A. Day MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
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  • Shaun A. Nguyen MD, MA,

    1. Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
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  • M. Boyd Gillespie MD, MSc

    1. Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

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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