Long-Term Swallowing Outcomes Following Thyroidectomy: Clinical Determinants of Persistent Swallowing Symptoms in Endocrine Surgical Oncology Care

Background and Objectives: This study was conducted to assess changes in swallowing function in thyroidectomy patients and to identify clinical risk factors associated with persistent patient-reported swallowing symptoms. Methods: The study was a retrospective, observational study. Data were collected from 280 patients who underwent total thyroidectomy between January 2022 and January 2025. Swallowing function was assessed using the Turkish Eating Assessment Tool-10 (T-EAT-10). Multivariate logistic regression analysis was employed to identify independently associated factors for persistent patient-reported swallowing symptoms, and receiver operating characteristic (ROC) analysis was used to assess the discriminative performance of continuous variables. Results: Patient-reported T-EAT-10 scores changed significantly during the follow-up period (χ2 = 217.33, p < 0.001). Post hoc analyses revealed that dysphagia scores decreased significantly at the 6th and 12th months postoperatively (p < 0.001). Persistent patient-reported swallowing symptoms were detected in 24 (8.6%) out of 279 patients who had a full 12-month T-EAT-10 follow-up. Multivariate logistic regression analysis showed that postoperative and preoperative dysphonia, body mass index (BMI), and malignant pathology were independently associated with persistent patient-reported swallowing symptoms. In the ROC analysis, the approximate clinical exploratory threshold values were 29 mm (AUC = 0.692) for nodule size and 100 min (AUC = 0.660) for operation time. Internal cross-validation analysis showed that the model’s discriminative performance was preserved, with a mean cross-validated AUC value of 0.801. Conclusions: Dysphagia following thyroidectomy typically resolves over time. However, the presence of preoperative and postoperative dysphonia appears to be a strong indicator of the development of persistent patient-reported swallowing symptoms.