Assessment Of Dysphagia In Patients With Enlarged Thyroid Gland Using Ent Diagnostic Techniques
Keywords:
FEES, Laryngoscopy, Dysphagia, Thyroid EnlargementAbstract
ABSTRACT
Background: An enlarged thyroid gland otherwise known as a goiter has the potential to cause swallowing difficulties (dysphagia) as it may compress and modify the functionality of the larynx. An otolaryngologist’s timely evaluation may elucidate the etiological and pathophysiological aspects leading to the dysphagia. An endoscopic examination provides a direct view that enables the appreciation of laryngeal displacement, laryngeal elevation, and pharyngeal constriction or narrowing, thereby enhancing the assessment of dysphagia and helping to develop a targeted treatment plan.
Objectives: To evaluate the routine ENT diagnostic method techniques in estimating proportions as well as the severity of endoscopic dysphagia features relative to the size of the thyroid glands, and to explore associations with thyroid volumetry and structural deviation.
Methodology: Clinically and radiologically enlarged thyroid glands from the Department Of ENT Kabir Medical College, Peshawar from july 2023 to july 2024 .were gathered for this cross-sectional study which involved 100 patients. Each patient underwent an ENT evaluation which involved indirect laryngoscopy, flexible nasopharyngolaryngoscopy, and FEES. Th e ultrasound was used to determine the size of the thyroid and the degree of tracheal deviation. To assess dysphagia, EAT-10 was used. Analysis of the data was carried out using SPSS v24, deeming p < 0.05 to be statistically significant.
Results: Among 100 patients he average age was 42.3 years (SD, 10.4 years). Dysphagia was present in 52.0% of the patients. Persistent endoscopic retrospective findings uncovered bulging of the posterior pharyngeal wall in 34.0%, laryngeal elevation was restricted in 22.0%, and valleculate residues were evident in 18.0%. Dysphagia was significantly associated with Treichel deviation of 5 mm or more (p = 0.018). Mild to moderate pharyngeal stage impairment in 28% of symptomatic patients were the result of FEES. Greater volumes of thyroids were statistically significant for the elevation of EAT-10 scores (p = 0.032).
Conclusion: Patients with enlarged thyroid glands often report difficulty swallowing dysphagia which can be attributed to structural displacement and dysfunctional pharyngeal biomechanics. Objective assessment to the degree of early functional compromise is possible with ENT diagnostic methodology particularly Flexible Endoscopic Evaluation of Swallowing (FEES) and flexible laryngoscopy. Adding these assessments to routine evaluations of the thyroid improves the accuracy of diagnoses and informs the timely implementation of management options and reduction of morbidity.
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