Impact of Sternothyroid Muscle Division on Patient-Reported Swallowing Outcomes After Thyroid Surgery: A Prospective Study

Sunday, September 29, 2024

2:48 PM – 2:54 PM EDT

Location: MBCC, 209

Disclosure(s):

Joshua D. Barlow, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Susmita Chennareddy, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Raymond L. Chai, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Division of the sternothyroid muscle during thyroidectomy is a widely accepted surgical technique to provide improved exposure of the thyroid gland, superior pole vessels, and the external branch of the superior laryngeal nerve. Our group had previously shown no decrement in postoperative voice outcomes with this technique. However, given the known role of the sternothyroid muscle in swallowing function, further research is necessary to determine the impact of this surgical technique on postoperative dysphagia.

Methods: This was a prospective, consecutive cohort study enrolling adult patients who underwent total thyroidectomy or lobectomy with a single surgeon between November 2022 and July 2023. Patients with clinical evidence of significant preoperative dysphagia were excluded. Complete sternothyroid muscle division was performed in all cases. The integrity of the recurrent laryngeal nerve and external branch of the superior laryngeal nerve (when visualized) were confirmed through intraoperative nerve monitoring and postoperative flexible laryngoscopy. Differences between pre and postoperative patient-reported swallowing outcomes were assessed using the Eating Assessment Tool-10 (EAT-10).

Results: A total of 114 patients were ultimately included in the study. No statistically significant difference was found between mean pre and postoperative EAT-10 scores (0.63 vs 0.75, p = 0.677). These results remained consistent regardless of sex, history of reflux, unilateral or bilateral sternothyroid muscle division, performance of substernal resection of goiter, and final histologic diagnosis.

Conclusions: Division of the sternothyroid muscle during thyroidectomy can be useful in exposure of the thyroid gland without impact on patient‐perceived swallowing disturbance.

Presenting Author(s)

Joshua D. Barlow, MD

Resident
NYU Langone Health
New York, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

BL

Benjamin Laitman, MD, PhD

Icahn School of Medicine at Mount Sinai, United States

Disclosure information not submitted.
JN

Juan Nogues, MD

Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai
New York, New York, United States

Disclosure information not submitted.
Susmita Chennareddy, BA

Medical Student
Icahn School of Medicine at Mount Sinai
New York, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Christine L. Barron, MD

Resident
Mount Sinai Hospital
New York, NY, United States

Disclosure information not submitted.

Senior Author(s)

Raymond L. Chai, MD

Associate Professor
Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai
New York, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.