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Substernal goiter and laryngopharyngeal reflux
Mariana Gonçalves Rodrigues1, Vergilius José Furtado de Araujo2, Leandro Luongo de Matos2
1Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil.
Archives of Endocrinology and Metabolism
|June 29, 2017
Summary
Substernal goiters are linked to a higher prevalence of laryngopharyngeal reflux signs compared to cervical goiters. This finding suggests substernal goiters increase the risk of reflux laryngitis in patients undergoing thyroidectomy.
Area of Science:
- Otorhinolaryngology
- Endocrinology
- Gastroenterology
Background:
- Voluminous goiters can extend substernally, potentially impacting adjacent structures.
- Laryngopharyngeal reflux (LPR) presents diagnostic challenges, especially in patients with thyroid conditions.
Purpose of the Study:
- To compare the prevalence of LPR signs in patients with substernal goiters versus voluminous cervical goiters undergoing thyroidectomy.
- To identify potential associations between goiter type and LPR.
Main Methods:
- Retrospective case-control study of thyroidectomy patients (2010-2014).
- Groups: substernal goiters vs. voluminous cervical goiters without thoracic extension.
- Diagnosis of substernal goiter based on clinical criteria; cervical goiter size by ultrasonography.
Main Results:
- Substernal goiters had significantly greater average thyroid volume (p < 0.001).
- Prevalence of LPR signs on laryngoscopy was significantly higher in the substernal goiter group (p = 0.036).
- Substernal goiter was an independent predictor of LPR signs (OR = 2.75, p = 0.039).
Conclusions:
- A significant association exists between substernal goiters and preoperative LPR signs.
- Substernal goiters increase the likelihood of LPR signs compared to voluminous cervical goiters.
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