Impact of Manual Therapy on Laryngeal Function Following Total Thyroidectomy
Johns Hopkins University
20 participants
Jun 3, 2024
INTERVENTIONAL
Conditions
Summary
In this clinical trial, the investigators are seeking to learn if a course of voice therapy, including neck massage, stretches and pain science education in addition to voice exercise and scar massage will effectively treatment patient complaints of swallowing or voice changes after total thyroidectomy as compared to voice exercise and scar massage alone. The main questions it aims to answer are: Will neck massage, stretches and pain science education reduce patient complaints of swallowing changes after total thyroidectomy? Will neck massage, stretches and pain science education reduce patient complaints of voice changes after total thyroidectomy? Will neck massage, stretches and pain science education reduce patient complaints of scar tethering and quality changes after total thyroidectomy? Will neck massage, stretches and pain science education improve quality of life after total thyroidectomy? Participants will: Participate in 4 visits with the participant's endocrine/laryngology surgeon. One prior and 3 after surgery for endoscopic evaluation and tests. Participate in 5 Speech-Language Pathology Sessions for intervention exercises and tests. One prior and 4 after surgery. Complete a journal of the participant's Home Exercise Practice
Eligibility
Inclusion Criteria3
- The study population consists of individuals with malignant or benign thyroid disease scheduled to undergo total thyroidectomy
- native speakers of English
- All patients will be greater than or equal to 18 years of age
Exclusion Criteria11
- Participants will be excluded if they have completed voice therapy prior
- are current smokers
- have organic vocal fold pathology or clear mucosal changes to the vocal folds that can affect vibration (e.g., vocal fold scar, polyp, or nodules),
- pre-existing unilateral or bilateral vocal fold paralysis
- have had prior surgical neck or chest history including central or lateral neck dissection
- pre- or post-operative abscess or inflammation
- have a history of radiation, chronic cervical pain or cervicalgia, abnormal baseline swallowing
- have underlying and, or plan to change supplemental hormones
- greater than 10% otherwise unexplained weight loss
- had a recent aspiration pneumonia
- history of esophageal interventions or surgeries
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Interventions
Manual massage applied to the anterior neck, including hyolaryngeal elevators, depressors, sternocleidomastoid.
Description of how the pain system works from a neurobiological level, discussing the biopsychosocial model that influences pain.
Bilateral cervical side bending, cervical extension and bilateral rotational neck stretches held for 20 seconds x3.
Digital manipulation of the scar itself in circles.
Stemple Voice Exercises
Will apply extremely light manual contact to the anterior neck, including hyolaryngeal elevators, depressors, sternocleidomastoid.
Will discuss how pain will as a result of the surgical intervention.
Will ask patient to look down as a neck stretch held for 20 seconds x3.
Locations(2)
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NCT06383091