Post-thyroidectomy anterior neck dysfunction: clinical phenotypes, mechanisms, and comprehensive management

Thyroid surgery is generally safe; however, satisfactory postoperative recovery is not determined solely by traditional complications such as recurrent laryngeal nerve injury, bleeding, or hypocalcemia. A subset of patients develop interrelated symptoms-including voice changes, swallowing discomfort, anterior neck pain or tightness, restricted cervical mobility, and sensory abnormalities-that are considered here within a proposed framework of post-thyroidectomy anterior neck dysfunction. In this review, the term is used as a working conceptual framework rather than a formally established diagnostic entity. Plausible mechanisms include neural injury, anterior neck muscle injury, restricted laryngotracheal motion, adhesion and fibrosis, and altered sensory input. Using a structured narrative synthesis of the available literature, we summarize the clinical phenotypes, natural history, potential mechanisms, risk factors, assessment tools, and prevention and treatment strategies relevant to this framework.