Post-thyroidectomy Distress: Voice and Swallowing Impairment Following Thyroidectomy

Thyroid surgery poses inherent risks to the functions of the larynx that include swallowing, breathing, coughing and phonation. While permanent voice hoarseness is perhaps the most discussed potential complication, it is also fortunately the rarest when compared to the spectrum of voice and swallowing changes observed after surgery. These impairments are reviewed here from the vantage points of anatomy, aetiology and character of the deficits, and options for evaluation and therapy. Direct injuries to the recurrent laryngeal nerve or external branch of the superior laryngeal nerve lead to well-described deficits. However, some patients are asymptomatic despite such injuries. Conversely, a variety of objective and subjective problems related to voice and swallowing can occur in the absence of laryngeal nerve injury. This chapter highlights new contributions to the knowledge of such 'post-thyroidectomy distress' and provides relevant clinical tactics to consider for perioperative care of patients with thyroid disease.