XXXX in adults: management algorithm based on swallowing outcomes.

@entity1 @entity515 @entity15708 @entity1224
OBJECTIVE: To review the presentation, workup, and functional outcomes of adult @entity1 diagnosed with @entity15708 treated by transoral subtotal excision. These results were then used to formulate a management algorithm. DESIGN: Retrospective chart review (2001-2008). SETTING: Tertiary care academic hospital. @entity1 : All @entity1 diagnosed with a @entity15708 as an adult were identified in the University of Alberta's head and neck mass database. Charts were reviewed for initial presentation, diagnostic methods, radiographic findings, and treatment and follow-up results. INTERVENTION: @entity15708 . MAIN OUTCOME MEASURE: Postoperative swallowing function as measured by pharyngeal residue and aspiration on videofluoroscopic swallowing studies. RESULTS: Five @entity1 with @entity15708 meeting the study criteria were identified. All were females aged 29 to 58 years (mean 44 years). Presentations ranged from asymptomatic to acute @entity1224 . Diagnosis was made with flexible nasopharyngoscopy, thyroid scintigraphy, and computed tomography. All @entity1 underwent transoral subtotal excision of their thyroids with either a @entity515 laser or electrocautery. Two @entity1 complained of residual symptoms and received adjunctive 131I, which led to symptom resolution. Pathologic evaluation revealed benign thyroid tissue. Swallowing function remained efficacious and safe in all @entity1 , as shown by a lack of aspiration and low pharyngeal residue scores. These results were used to propose a management algorithm for the spectrum of adult-diagnosed @entity15708 . CONCLUSIONS: Transoral subtotal excision of @entity15708 provides adequate resection of the lesion with good postoperative swallowing function. When appropriate, this is advocated as the treatment modality of choice.
