This project aims to evaluate the association of frailty with post-operative changes in voice, swallowing, and quality of life following thyroidectomy in older adults. Specifically, Aim 1 is to evaluate the effect of thyroidectomy on voice, swallowing, and quality of life in older adults. The literature suggests that these alterations occur at a relatively high frequency in younger patients.
We aim to quantify frequency and magnitude of changes in voice, swallowing, and QOL using subjective assessment with surveys and semi- structured patient interviews. Additionally we aim to correlate this with objective data obtained from speech- language pathology evaluations using videostroboscopy and videofluoroscopy.
In Aim 2, we will explore the associations between a frailty phenotype with pre-operative findings, thyroid-specific markers, and post- thyroidectomy alterations in voice, swallowing or decline in QOL. In addition to exploring the role of frailty to predict these alterations and identify a high-risk group, we will also explore the utility of thyroid or laryngeal specific markers to augment the predictive power of frailty.
In Aim 3, we hope to investigate the role of pre- operative interventions including tracheal traction exercises and voice therapy to reduce the incidence of impact of post-operative alterations. We will randomize patients to intervention or usual care and evaluate the frequency of alterations after thyroidectomy. This work represents an interdisciplinary approach to establish alterations in voice and swallowing that occur after thyroidectomy in older individuals, the impact of these changes on quality of life, and an attempt to reduce post-surgical disability. Findings from this study will inform the design of 2 future clinical trials aimed at 1) evaluating pre-operative interventions to reduce surgical disability after thyroidectomy and 2) creating a patient-reported outcome measurement tool specifically for older adults undergoing thyroidectomy.
Voice and swallowing alterations have a daily impact on interaction with family and friends, quality of life, and participation in society, and difficulty taking medications. These alterations occur in up to 40% of younger individuals after thyroidectomy. We aim to quantify changes in voice, swallowing, and quality of life in older adults after thyroidectomy, assess its association with frailty, and attempt to reduce these changes by implementing pre-operative therapy in high-risk patients. Improved understanding of which patients are likely to develop voice and swallowing complications will help guide clinicians with informed consent and encourage early preventative measures.
| Sahli, Zeyad; Najafian, Alireza; Kahan, Stacie et al. (2018) One-Hour Postoperative Parathyroid Hormone Levels Do Not Reliably Predict Hypocalcemia After Thyroidectomy. World J Surg 42:2128-2133 |
| Sahli, Zeyad; Canner, Joseph K; Najjar, Omar et al. (2018) Association Between Age and Patient-Reported Changes in Voice and Swallowing After Thyroidectomy. Laryngoscope : |
| Sahli, Zeyad T; Zhou, Sheng; Najjar, Omar et al. (2018) Octogenarians have worse clinical outcomes after thyroidectomy. Am J Surg 216:1171-1176 |
| Sahli, Zeyad T; Ansari, Ghedak; Gurakar, Merve et al. (2018) Thyroidectomy in older adults: an American College of Surgeons National Surgical Quality Improvement Program study of outcomes. J Surg Res 229:20-27 |
