this is the second part of the swallowing assesment course focusing on Dysphagia from Diagnosis to Treatment: Algorithmic Decisions and Clinical Strategies

Instrumental assessment plays a crucial role in the evaluation of pediatric dysphagia, offering objective insights that guide diagnosis and management. The two primary modalities—Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Videofluoroscopic Swallowing Study (VFSS)—each offer distinct advantages, but selecting the appropriate tool remains a matter of clinical judgment, patient factors, and institutional resources.

This session will explore the comparative value of FEES and VFSS in the instrumental assessment of swallowing in children. It will address their indications, safety considerations, and the nuances of interpreting results in a pediatric population. Emphasis will be placed on age-specific challenges, including developmental anatomy, cooperation level, and feeding patterns. Through case examples and interactive discussion, the session aims to support clinicians in making evidence-based decisions tailored to individual patients.

In addition, I will delve into the preliminary findings of our own clinical study directly comparing both modalities in a pediatric population.

SUMMARY: Total thyroidectomy is often performed in head and neck surgery and is considered a less complicated procedure, but is still accompanied by a number of complications, the most common of which are recurrent lesions and endocrinological ones in the form of impaired regulation of hormonal status and disorders of calcium metabolism. The aim of the study was to examine the role and significance of total thyroidectomy for the occurrence of postoperative complications in correlation with pathohistological and endocrinological findings.

Methods: A cross-sectional study included 90 patients over 18 years of age, both sexes, in the period from 2022 to 2024, who underwent thyroid surgery at the University Clinical Center of the Republic of Srpska. Preoperatively, hormonal analyses and thyroid ultrasound examination as well as endovideolaryngoscopy examination (EVLS) were performed. Total thyroidectomy was performed in all patients. Postoperatively, pathohistological diagnostics, control hormonal analyses, and EVLS examination were performed.

Results: The most common indication for surgical intervention was goiter in women 81 (90%) with an average age of 54.18 years. Laryngeal symptoms in the form of hoarseness, cough, dyspnea and dysphagia after surgery were reported by 13 (14.4%). Paresis of the nerve recurrence was reported by 11 (12.2%), PH analysis showed that in the majority of cases it was goiter37 (41.1%), followed by follicular adenoma25 (27.8%) and papillary carcinoma18 (20%), the remaining 10 (11%) had endocrinological complications. 23.25% Hypocalcemia 67(74.4%) of which 16(17.8) severe form <1.9 mmol/l elevated PTH values 4.4%.

CONCLUSION: Patients with vocal cord paresis and hypocalcemia show the highest incidence of postoperative complications after total thyroidectomy due to histopathologically diagnosed goiter, follicular adenoma, and papillary thyroid carcinoma. These findings may be potentially useful in identifying elderly patients at increased risk of complications after total thyroidectomy that may significantly affect their quality of life.

Diseases of the thyroid and parathyroid glands—both endocrine organs—are frequently encountered in worldwide. Approximately 5–15% of all thyroid nodules are malignant in nature. Thyroid cancers account for about 90% of all endocrine neoplasms. Reported rates of metastasis to the central and lateral neck compartments in thyroid cancers range from 20% to 80%.

Diagnosis, treatment, and follow-up of diseases of these organs require a multidisciplinary approach involving Endocrinology, Nuclear Medicine, Pathology, and Surgery. In recent years, various surgical approaches such as lobectomy, total thyroidectomy, central lymph node dissection, and minimally invasive thyroidectomy have been applied, differing from past practices. With the advancement of technology, endoscopic and robotic surgery have also been introduced into thyroid surgery in recent years.

Although guidelines set forth by the American and European Thyroid Associations exist for surgical management of thyroid diseases, different surgical practices are preferred in various parts of the world. Due to the location of the thyroid in the neck and the potential complications of its surgery—such as recurrent or superior laryngeal nerve injury, tracheal or laryngeal trauma, and swallowing difficulties—this topic is of particular importance to the specialties of Otorhinolaryngology and Head & Neck Surgery.

The most effective way to avoid complications is a thorough knowledge of the surgical anatomy of these organs and mastery of surgical techniques.

In this course, current thyroid surgery techniques and methods to prevent possible complications will be presented, accompanied by visual educational materials.

this is a panel about Long Survivorship Post Neck Radiation: Dysphagia, dysphonia and dyspnea management