Association of Fraility with Post thyroidectomy alterations in Voice, Swallowing, and Quality of Life

虚弱与甲状腺切除术后声音、吞咽和生活质量改变的关系

• 批准号: 10153605
• 负责人: Aarti Mathur
• 金额: $ 16.96万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-04-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10153605
• 关键词: Age; Anterior; Atrophic; Auditory; Cervical spine; Clinical; Clinical Trials; Complication; Consensus; Data; Deglutition; Deglutition Disorders; Development; Elderly; Endocrine; Esophagus; Evaluation; Exercise; Exercise Therapy; Family; Fluoroscopy; Frequencies; Friends; Functional disorder; Funding; Future; Goiter; Incidence; Individual; Informed Consent; Intervention; Intervention Studies; Interview; Language; Laryngeal muscle structure; Larynx; Literature; Malignant neoplasm of thyroid; Measurement; Measures; Muscle; Nerve; Operative Surgical Procedures; Outcome; Pathologist; Patient Outcomes Assessments; Patients; Personal Satisfaction; Pharmaceutical Preparations; Phenotype; Physiological; Postoperative Period; Preventive measure; Quality of life; Randomized; Recurrence; Reporting; Risk; Role; Societies; Speech; Speech-Language Pathology; Spine surgery; Stroboscopy; Structure; Structure of superior laryngeal nerve; Surgeon; Surrogate Markers; Surveys; Therapeutic Intervention; Thyroid Gland; Thyroid Nodule; Thyroidectomy; Thyrotropin; Trachea; Traction; Voice; Voice Disorders; Work; base; cartilaginous; cohort; design; disability; frailty; high risk; high risk population; improved; indexing; interdisciplinary approach; muscle form; muscle strength; nerve injury; prophylactic; prospective; sarcopenia; tool; treatment as usual; voice therapy; young adult

Project Summary This project aims to evaluate the association of frailty with post-operative changes in voice, swallowing, and quality of life following thyroidectomy in older adults. Specifically, Aim 1 is to evaluate the effect of thyroidectomy on voice, swallowing, and quality of life in older adults. The literature suggests that these alterations occur at a relatively high frequency in younger patients. We aim to quantify frequency and magnitude of changes in voice, swallowing, and QOL using subjective assessment with surveys and semi- structured patient interviews. Additionally we aim to correlate this with objective data obtained from speech- language pathology evaluations using videostroboscopy and videofluoroscopy. In Aim 2, we will explore the associations between a frailty phenotype with pre-operative findings, thyroid-specific markers, and post- thyroidectomy alterations in voice, swallowing or decline in QOL. In addition to exploring the role of frailty to predict these alterations and identify a high-risk group, we will also explore the utility of thyroid or laryngeal specific markers to augment the predictive power of frailty. In Aim 3, we hope to investigate the role of pre- operative interventions including tracheal traction exercises and voice therapy to reduce the incidence of impact of post-operative alterations. We will randomize patients to intervention or usual care and evaluate the frequency of alterations after thyroidectomy. This work represents an interdisciplinary approach to establish alterations in voice and swallowing that occur after thyroidectomy in older individuals, the impact of these changes on quality of life, and an attempt to reduce post-surgical disability. Findings from this study will inform the design of 2 future clinical trials aimed at 1) evaluating pre-operative interventions to reduce surgical disability after thyroidectomy and 2) creating a patient-reported outcome measurement tool specifically for older adults undergoing thyroidectomy.

项目概要 该项目旨在评估虚弱与术后声音、吞咽和动作变化之间的关系。 老年人甲状腺切除术后的生活质量。具体来说，目标 1 是评估以下效果： 甲状腺切除术对老年人声音、吞咽和生活质量的影响。文献表明这些 年轻患者的改变发生频率相对较高。我们的目标是量化频率和 使用调查和半定量的主观评估来评估声音、吞咽和生活质量的变化幅度 结构化的患者访谈。此外，我们的目标是将其与从语音中获得的客观数据相关联—— 使用视频频闪镜和视频荧光镜进行语言病理学评估。在目标 2 中，我们将探索 虚弱表型与术前表现、甲状腺特异性标志物和术后表现之间的关联 甲状腺切除术会改变声音、吞咽或生活质量下降。除了探索虚弱的作用之外 为了预测这些变化并确定高危人群，我们还将探索甲状腺或喉癌的效用 增强虚弱预测能力的特定标记。在目标 3 中，我们希望研究预训练的作用。 手术干预包括气管牵引练习和声音治疗，以减少发生率 术后变化的影响。我们将随机对患者进行干预或常规护理，并评估 甲状腺切除术后改变的频率。这项工作代表了一种跨学科的方法来建立 老年人甲状腺切除术后声音和吞咽的改变，这些影响 生活质量的改变，并尝试减少术后残疾。这项研究的结果将告知 设计 2 项未来临床试验，旨在 1) 评估术前干预措施，以减少手术次数 甲状腺切除术后的残疾；2) 创建一个患者报告的结果测量工具，专门用于 接受甲状腺切除术的老年人。