Thyroidectomy-Related Dysphagia: A Systematic Literature Review

Background and Objectives: Dysphagia is a frequently reported symptom among patients undergoing thyroidectomy, yet its incidence, underlying mechanisms, and temporal progression remain insufficiently clarified. The aim of the present systematic review was to synthesize the existing literature on the occurrence and evolution of swallowing disorders following thyroidectomy, without restriction regarding the extent of surgery, surgical approach, indication, or concomitant complications. Materials and Methods: A systematic literature review, according to PRISMA guidelines, was conducted in the electronic databases PubMed, MEDLINE, and SciELO, using the terms "dysphagia", "deglutition disorder", "swallowing disorder", "thyroid surgery" and "thyroidectomy" in the appropriate combinations. A narrative synthesis of the results followed. Results: 31 eligible studies encompassing a total of 64,123 patients were included in the systematic review and analyzed concerning their type, sample, follow-up and results regarding thyroidectomy-related dysphagia. Data regarding pre- and postoperative dysphagia were extracted and compared. Both subjective patient-reported outcomes and objective assessments were considered. Reported preoperative dysphagia incidence varied widely (3.3-77.8%), with a pooled mean of approximately 25%. Dysphagia rates increased significantly within the first 1-2 postoperative weeks but generally declined to near preoperative levels by 2-3 months, with further improvement observed up to 4-6 months. Several factors were associated with persistent or more severe dysphagia, including the extent of surgery, older age, surgical techniques, central or lateral lymph node dissection, and the need for adjuvant therapies such as radioactive iodine or external beam radiotherapy. Conclusions: Dysphagia after thyroidectomy appears as a common but typically transient symptom, with the highest incidence occurring in the immediate postoperative period and a progressive return to baseline within three months. Although most patients experience improvement, a subset may report persistent symptoms with measurable impact on quality of life. Methodological heterogeneity, variability in symptom assessment tools, and limited long-term follow-up restrict the strength of available evidence. Standardization of outcome measures and longer follow-up periods are needed to achieve more reliable and generalizable conclusions.