J Korean Thyroid Assoc.  2014 May;7(1):70-76.

Early Neck Exercises to Reduce Post-Thyroidectomy Syndrome after Uncomplicated Thyroid Surgery: A Prospective Randomized Study

• Jang JY
• Chang YS
• Kim EH
• Moon JH
• Son YI

Abstract

BACKGROUND AND OBJECTIVES
To evaluate the efficacy and safety of early neck exercises to reduce post-thyroidectomy symptoms and syndromes for patients undergoing thyroid surgery.
MATERIALS AND METHODS
One hundred patients who had undergone thyroid surgery were randomly assigned 1:1 to control (delayed exercise, initiating at postoperative 2 weeks) or early exercise group (initiating at postoperative 1 day). Questionnaire survey (voice, globus sense, neck discomfort, swallowing difficulty) and objective measurement (surgical wound adhesion, range of neck motion and scar scale) were performed at 2 weeks and 3 months postoperatively.
RESULTS
Compared to control, early exercise significantly decreased the degree of neck discomfort at 2 weeks after thyroid surgery (p=0.037) while other subjective symptoms including voice change, globus sense, and swallowing difficulty were not significantly different between the two groups. The degree of surgical wound adhesion was significantly decreased (p<0.001) and the range of motion was improved in early exercise group (p=0.010). In addition, the objective scores of Vancouver Scar Scale (VSS) were decreased in early exercise group compared to those of control group (p=0.020).
CONCLUSION
Early neck exercises are safe and effective to reduce postoperative neck discomfort, wound adhesion, or hypertrophy of scar and to improve the range of motion in patients undergoing thyroid surgery.

Keyword

Neck exercise; Thyroid surgery; Post-thyroidectomy syndrome; Post-operative neck discomfort

MeSH Terms

Cicatrix
Deglutition
Exercise*
Humans
Hypertrophy
Neck*
Prospective Studies*
Surveys and Questionnaires
Range of Motion, Articular
Thyroid Gland*
Voice
Wounds and Injuries

Figure

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  Fig. 1. Clinical pathway. LND: lateral neck dissection, MRND: modified radical neck dissection, POD: postoperative day, RLN: recurrent laryngeal nerve, SLN: superior laryngeal nerve.

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  Fig. 2. Korean version of neck exercise protocols.

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  Fig. 3. Comparison of subjective indices between control and early exercise groups at post-operative 2 weeks and 3 months. Statistical significance was set at p<0.05.

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  Fig. 4. Comparison of objective indices including the surgical wound adhesion (A) and the range of neck motion (B) between control and early exercise groups at post-operative 2 weeks and 3 months. Statistical significance was set at p<0.05.

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  Fig. 5. Comparison of the total VSS scores between control and early exercise groups at post-operative 2 weeks and 3 months. VSS: Vancouver Scar Scale. Statistical significance was set at p<0.05.

Reference

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