Endocrine Abstracts (2004) 7 P245

Does thyroidectomy exacerbate or relieve the throat symptoms of globus pharyngeus?

J England1, D Hayworth1, A Hayden1, S Nadig1, P Nix1 & SL Atkin2

1Department of Otolaryngology Head and Neck Surgery, Hull Royal Infirmary, UK; 2Division of Academic Medicine, University of Hull Postgraduate Medical Insitute, UK.

Objective. Globus pharyngeus is a term used to describe an abnormal throat sensation in the absence of any pathological cause. A thyroid goitre is one of the pathologies that needs to be excluded prior to making the diagnosis as it is thought that a goitre may cause similar symptoms. However, it is well recognised that postoperatively thyroidectomy patients complain of globus type symptoms.It is also recognised that most thyroidectomies are carried out in middle aged women and globus pharyngeus tends to occur maximally in this population subgroup.

Method. To investigate the relationship between thyroidectomy and globus we used the validated Glasgow-Edinburgh throat scale (10 throat specific questions, 2 somatic distress symptom questions) to compare symptoms pre and post thyroidectomy. This was completed by 41 consecutive patients undergoing thyroidectomy (Benign goitre N=18, Papillary carcinoma N=8, Graves disease n=10, Thyroiditis n=2, Adenoma n=3) preoperatively and at one year postoperatively. Sixteen patients had a hemithyroidectomy and 25 had a total thyroidectomy. A subset of 25 patients were also studied at 3 months postoperatively.

Results. It was found that thyroidectomy did not worsen globus symptoms and indeed caused significant improvement (p<0.05) in four out of ten throat specific symptoms ('Discomfort/irritation in the throat', 'Swelling in the throat', 'Want to swallow all the time', 'Feeling of something stuck in the throat') and both the somatic distress symptoms at one year ('How much time do you spend thinking about your throat?', 'At present, how annoying do you find your throat sensation?').

Conclusion. These data are of particular importance to the practicing clinician in being able to offer reassurance and advice to patients complaining of these symptoms, before and after thyroid surgery.

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