Morbidity after thyroid surgery in children: patient perspective

Abstract

Abstract Aim To explore the children’s/parents’ perception of morbidity after thyroid surgery. Methods Retrospective analysis of consecutive unselected patients who had undergone a thyroid operation under joint care of Paediatric and Endocrine surgeons. Electronic patients records were used to obtain relevant information and a standardised questionnaire was mailed to all children. Results Between Jan2009- Dec2020 62 children age 2–18 (median 15.2) had thyroid lobectomy (n=27) or total thyroidectomy (n=35). In-hospital stay ranged 1–3 days (mode1). Replies were received from 20 children at a median 37 months (range 5–60 months) after lobectomy (n= 8) or total thyroidectomy (n=12). Subjective voice assessment using a visual analogue scale remained normal in all children. Voice handicap index scores were normal in 13 (65%) children and increased in 7 (35%) to a median of 4 (range 1–10). Voice-related quality of life was excellent in 18 (90%) children and very good in two children. Swallowing was normal in 14 children, moderately affected in four children and severely affected in 2 children. Appearance of the scar assessed using the Manchester score ranged from 5–16, median 9, with only one child with an ideal score of 5. Three children have had or are waiting for scar revision. There was no persistent hypoparathyroidism. Conclusion In this cohort of children undergoing thyroid surgery, there were no significant voice changes and swallowing morbidity was infrequent. Concerns related to scar appearance were far more common than in the adult population and this should be highlighted in the consent process.