After a thyroidectomy, which follow-up evaluation is most appropriate for a patient complaining of coughing when drinking and dysphonia?

Choosing to utilize fiberoptic endoscopic evaluation of swallowing (FEES) is particularly appropriate for a patient experiencing coughing while drinking and dysphonia following a thyroidectomy due to several reasons.

After thyroid surgery, patients can often experience complications that affect swallowing and voice due to potential damage to surrounding structures, including the larynx and other components of the swallowing mechanism. FEES allows for direct visualization of the pharynx, larynx, and the swallow response. This method is especially valuable as it provides insights into the patient’s swallowing function in real-time while assessing the presence of aspiration (food or liquid entering the airway) and other swallowing pathologies.

Additionally, FEES can help identify the sites of dysfunction and assess the quality of voice, which is essential given the dysphonia reported by the patient. This endoscopic approach is performed at the bedside and can be done quickly, making it a practical choice for identifying immediate concerns post-thyroidectomy.

Other potential follow-up evaluations, though relevant in different contexts, do not provide the same advantages as FEES for this specific set of symptoms. They may focus on different aspects of swallowing or may not offer real-time feedback on the swallowing process itself. Thus, FEES stands out as the