Following a thyroidectomy, which post-treatment follow-up evaluation is most appropriate for a patient with swallowing issues?

The most appropriate follow-up evaluation for a patient experiencing swallowing issues after a thyroidectomy is utilizing a fiberoptic endoscopic evaluation of swallowing (FEES). This method allows for direct visualization of the pharynx and larynx during the swallowing process, providing crucial information about any functional abnormalities. Following thyroid surgery, patients may have alterations in their swallowing mechanics due to changes around the larynx or pharynx, making FEES valuable for assessing the integrity and function of these structures.

FEES also allows clinicians to evaluate the swallowing function in real-time and observe the effects of various food consistencies on the patient's ability to swallow safely. This detailed assessment helps identify whether there are any swallow safety issues, such as aspiration, and informs potential treatment strategies, swallowing rehabilitation, or dietary modifications.

In contrast, while a clinical swallow evaluation offers preliminary insights into a patient’s swallowing capabilities, it lacks the detailed visualization provided by FEES. Pharyngeal manometry tests assess pressure during swallowing but do not offer direct visualization, making them less suitable for initial evaluations of swallowing post-thyroidectomy. Similarly, a videofluoroscopic swallow study, though valuable, can be more time-consuming and may not provide the immediate visual feedback of FEES during the