Sensory symptoms in patients undergoing thyroidectomy. / Sintomas sensoriais em pacientes submetidos à tireoidectomia.

PURPOSE: To verify the occurrence of sensory symptoms in thyroidectomy patients pre- and post-operatively. METHODS: This is a prospective, quantitative, descriptive study conducted with a sample of twelve patients undergoing thyroidectomy. The participants underwent visual laryngeal examination and responded to the Upper Aerodigestive Symptoms (UADS) and Vocal Tract Discomfort Scale (VTDS) questionnaires before and after the surgery. RESULTS: There was higher occurrence of vocal fatigue, hoarseness, pharyngeal bolus, dry throat, and throat clearing preoperatively, whereas higher occurrence of hoarseness, vocal fatigue, cough, and pharyngeal bolus was observed postoperatively for the UADS. Regarding the VTDS sensory symptoms, higher frequency and severity of throat dryness were observed preoperatively, whereas more frequent tickling throat and more severe irritable and sore throat and lump in the throat were observed postoperatively. There was reduction in the choke symptom and in the frequency and severity of the throat dryness symptom pre- and post-operatively. With respect to the frequency and severity of vocal tract discomfort sensory symptoms, reduction in throat dryness was observed at both assessment times. CONCLUSION: The patients presented sensory symptoms of upper aerodigestive tract and vocal tract discomfort pre- and post-operatively characterized by self-reference of hoarseness, vocal fatigue, pharyngeal bolus, and cough, as well as dry, sore, and irritable throat. Reduction in the sensory symptom of choke and in the frequency and severity of throat dryness was self-reported by thyroidectomy patients postoperatively.

Sintomas sensoriais em pacientes submetidos à tireoidectomia / Sensory symptoms in patients undergoing thyroidectomy

RESUMO Objetivo Verificar a ocorrência dos sintomas sensoriais em pacientes pré e pós-tireoidectomia. Método Tratou-se de um estudo prospectivo, quantitativo e descritivo. Participaram 12 pacientes submetidos à tireoidectomia, que realizaram exame visual laríngeo e responderam aos questionários de Vias Aéreas Digestivas Superior e Escala de Desconforto do Trato Vocal pré e pós-cirurgia. Resultados Houve maior ocorrência de fadiga vocal, rouquidão, sensação de bolo na garganta, garganta seca e pigarro no pré-operatório. Houve maior ocorrência de rouquidão, fadiga, pigarro e sensação de bolo na garganta no pós-operatório. Quanto aos sintomas sensoriais de desconforto do trato vocal, no pré-operatório, houve maior frequência e intensidade de secura e, no pós-operatório, maior frequência de coceira e maior intensidade de garganta irritada, sensível e bola na garganta. Houve redução do sintoma de engasgo e da frequência/intensidade do sintoma de secura na garganta pré e pós-tireoidectomia. Em relação à frequência/intensidade dos sintomas sensoriais de desconforto do trato vocal, em ambos os momentos, houve redução da secura. Conclusão Os pacientes apresentam sintomas sensoriais de vias aéreas digestivas superiores e de desconforto do trato vocal tanto no pré quanto no pós-operatório, caracterizados pela autorreferência de rouquidão, fadiga vocal, sensação de bola na garganta e pigarro, assim como secura, garganta irritada, garganta sensível e bola na garganta. Houve redução na referência dos sintomas sensoriais de engasgo e frequência/intensidade de secura pós-tireoidectomia.

ABSTRACT Purpose To verify the occurrence of sensory symptoms in thyroidectomy patients pre- and post-operatively. Methods This is a prospective, quantitative, descriptive study conducted with a sample of twelve patients undergoing thyroidectomy. The participants underwent visual laryngeal examination and responded to the Upper Aerodigestive Symptoms (UADS) and Vocal Tract Discomfort Scale (VTDS) questionnaires before and after the surgery. Results There was higher occurrence of vocal fatigue, hoarseness, pharyngeal bolus, dry throat, and throat clearing preoperatively, whereas higher occurrence of hoarseness, vocal fatigue, cough, and pharyngeal bolus was observed postoperatively for the UADS. Regarding the VTDS sensory symptoms, higher frequency and severity of throat dryness were observed preoperatively, whereas more frequent tickling throat and more severe irritable and sore throat and lump in the throat were observed postoperatively. There was reduction in the choke symptom and in the frequency and severity of the throat dryness symptom pre- and post-operatively. With respect to the frequency and severity of vocal tract discomfort sensory symptoms, reduction in throat dryness was observed at both assessment times. Conclusion The patients presented sensory symptoms of upper aerodigestive tract and vocal tract discomfort pre- and post-operatively characterized by self-reference of hoarseness, vocal fatigue, pharyngeal bolus, and cough, as well as dry, sore, and irritable throat. Reduction in the sensory symptom of choke and in the frequency and severity of throat dryness was self-reported by thyroidectomy patients postoperatively.

Prevalence of HPV infection in head and neck carcinomas shows geographical variability: a comparative study from Brazil and Germany.

Rising prevalence rates of high-risk human papillomaviruses (hrHPV) infection in oropharyngeal carcinoma (up to 80 %) have been reported in North America and Scandinavia. We have analysed 424 German and 163 Brazilian head and neck squamous cell carcinomas (HNSCC) from the oral cavity (OSCC), oropharynx (OPSCC) and hypopharynx (HPSCC) using p16 immunohistochemistry, HPV DNA PCR and sequencing, hrHPV DNA in situ hybridisation (ISH) and hrHPV E6/E7 RNA ISH. In the German series, 52/424 cases (12.3 %) were p16-positive/hrHPV-positive (OSCC 3.8 % [10/265], OPSCC 34.4 % [42/122], HPSCC 0 % [0/37]). In addition, there were 9 cases that were p16-positive/hrHPV-negative (5 OPSCC and 4 OSCC). In the Brazilian series, the overall hrHPV DNA prevalence by PCR was 11.0 % ([18/163]; OSCC 6 % [5/83], OPSCC 15.5 % [11/71], HPSCC 22.2 % [2/9]). Ten of these cases were hrHPV-positive/p16-positive. The remaining 8 hrHPV-positive/p16-negative cases were also negative in both ISH assays. Furthermore, 5 p16-positive/hrHPV-negative cases (2 OPSCC and 3 OSCC) were identified. In both series, HPV16 was by far the most common HPV type detected. We confirm that regardless of geographical origin, the highest hrHPV prevalence in HNSCC is observed in oropharyngeal carcinomas. The proportion of HPV-associated OPSCC was substantially higher in the German cohort than in the Brazilian series (34.4 vs. 15.5 %), and in both groups, the prevalence of hrHPV in OPSCC was much lower than in recent reports from North America and Scandinavia. We suggest, therefore, that it may be possible to define areas with high (e.g. USA, Canada, Scandinavia), intermediate (e.g. Germany) and low (e.g. Brazil) prevalences of HPV infection in OPSCC.