Long-Term Swallowing Outcomes Following Thyroidectomy: Clinical Determinants of Persistent Swallowing Symptoms in Endocrine Surgical Oncology Care.

BACKGROUND AND

OBJECTIVES

This study was conducted to assess changes in swallowing function in thyroidectomy patients and to identify clinical risk factors associated with persistent patient-reported swallowing symptoms.

METHODS

The study was a retrospective, observational study. Data were collected from 280 patients who underwent total thyroidectomy between January 2022 and January 2025. Swallowing function was assessed using the Turkish Eating Assessment Tool-10 (T-EAT-10). Multivariate logistic regression analysis was employed to identify independently associated factors for persistent patient-reported swallowing symptoms, and receiver operating characteristic (ROC) analysis was used to assess the discriminative performance of continuous variables.

RESULTS

Patient-reported T-EAT-10 scores changed significantly during the follow-up period (χ2 = 217.33, p < 0.001). Post hoc analyses revealed that dysphagia scores decreased significantly at the 6th and 12th months postoperatively (p < 0.001). Persistent patient-reported swallowing symptoms were detected in 24 (8.6%) out of 279 patients who had a full 12-month T-EAT-10 follow-up. Multivariate logistic regression analysis showed that postoperative and preoperative dysphonia, body mass index (BMI), and malignant pathology were independently associated with persistent patient-reported swallowing symptoms. In the ROC analysis, the approximate clinical exploratory threshold values were 29 mm (AUC = 0.692) for nodule size and 100 min (AUC = 0.660) for operation time. Internal cross-validation analysis showed that the model's discriminative performance was preserved, with a mean cross-validated AUC value of 0.801.

CONCLUSIONS

Dysphagia following thyroidectomy typically resolves over time. However, the presence of preoperative and postoperative dysphonia appears to be a strong indicator of the development of persistent patient-reported swallowing symptoms.