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. 2025 Sep 16;18(1):45.
doi: 10.1186/s13044-025-00264-5.

Secondary analyses of swallowing efficiency and safety outcomes following thyroidectomy versus thyroidectomy plus prophylactic central neck dissection

Molly A Knigge  1 , Daniel Robbins  2 , Susan Thibeault  2 , Nadine Connor  3 , Rebecca Sippel  4
Affiliations

Secondary analyses of swallowing efficiency and safety outcomes following thyroidectomy versus thyroidectomy plus prophylactic central neck dissection

Molly A Knigge et al. Thyroid Res. .

Abstract

Background: Swallowing complaints are common following total thyroidectomy, though an exact mechanism of patient-reported swallowing symptoms following thyroidectomy is currently lacking. This secondary, blinded analysis of data collected in a randomized, controlled clinical trial hypothesized that patients randomly assigned to the central neck dissection group would exhibit increased aspiration and pharyngeal residue on videofluoroscopic swallowing evaluation, and reduced patient-rated swallowing outcomes, as compared to patients randomized to thyroidectomy alone. We further hypothesized that blinded analysis would reveal worse swallowing function two-weeks post-surgery when compared to their pre-operative status to explain qualitative patient-reported dysphagia symptoms.

Methods: Thirty-two participants randomized to total thyroidectomy treatment with or without central neck dissection underwent pre- and post-surgical evaluation of swallowing outcomes, including videofluoroscopic Penetration/Aspiration Scale ratings, Normalized Residue Ratio Scale measures of valleculae and pyriform sinus residue, and EAT-10 patient-rated outcomes.

Results: No statistically significant differences were found post-surgery between randomized treatment groups for patient-rated EAT-10 scores (p = 0.2406), penetration/aspiration scale (p = 0.4465) or Normalized Residue Rating Scale scores for either vallecular or pyriform sinus sites. When group data were combined for analysis of differences between pre- and post-operative swallow performance, no statistically significant differences were found in patient-rated EAT-10 scores (p = 0.1374), penetration/aspiration scale (p = 0.7588) or Normalized Residue Rating Scale scores.

Conclusions: Measures of penetration/aspiration and pharyngeal residue failed to substantiate perceptions of post-operative dysphagia reported by patients undergoing total thyroidectomy with or without central neck dissection.

Trial registration: ClinicalTrials.gov Identifier NCT02138214.

Keywords: Aspiration; Dysphagia; Neck dissection; Thyroidectomy.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethical approval: All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained for each participant under the approval of the University of Wisconsin – Madison Health Sciences Institutional Review Board (IRB 2014 − 0391). Consent to participate: Informed consent was collected for all participants enrolled in the IRB approved studies listed above.

Figures

Fig. 1
Fig. 1
Consort diagram
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References

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