Female sex, central lymph node metastasis and dissection are causes of globus symptom after thyroidectomy

Eur Arch Otorhinolaryngol. 2016 Jun;273(6):1607-13. doi: 10.1007/s00405-015-3676-8. Epub 2015 Jun 7.

Abstract

Globus symptoms are not uncommon after an uncomplicated thyroidectomy. However, their associated factors and etiology have not been investigated. We investigated the etiology and factors related to globus symptoms after thyroidectomy. The medical records of 289 patients who underwent thyroidectomy and completed a voice analysis, psychiatric screening, and voice-related questionnaires before and 1 month after the surgery were reviewed. Patients were excluded if they had globus symptoms before surgery or scored high on the psychiatric questionnaire. The selected patients were divided into two groups according to development of globus symptoms after surgery. Clinicopathological parameters and results of the voice analysis and voice-related questionnaires were compared between the two groups. A total of 157 patients were enrolled, and more than half (80/155, 51 %) showed development of globus symptoms 1 month after thyroidectomy. Female patients [hazard ratio (HR), 2.605; P = 0.010], patients who had central lymph node metastasis (HR, 3.533; P = 0.001), and patients who underwent central neck dissection (HR, 3.652; P = 0.014) had a higher probability of developing globus symptoms. Patients who developed globus symptoms scored higher on the voice-related questionnaire, and had a greater decrease in speaking fundamental frequency (P < 0.001). Globus symptoms developed after 1 month in more than half of patients who underwent thyroidectomy. Female sex and central lymph node metastasis and dissection increased the possibility of developing the symptoms.

Keywords: Central lymph node; Globus; Thyroidectomy; Voice.

MeSH terms

  • Adult
  • Aged
  • Dissection
  • Female
  • Foreign Bodies*
  • Humans
  • Lymph Node Excision
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neck Dissection / methods
  • Postoperative Complications*
  • Sensation Disorders / etiology*
  • Sex Factors*
  • Surveys and Questionnaires
  • Thyroid Neoplasms / pathology
  • Thyroidectomy / adverse effects*
  • Thyroidectomy / methods
  • Voice Disorders / etiology
  • Young Adult