Vaninder Dhillon

Assistant professor in the Divisions of Laryngology and Endocrine Head & Neck Surgery at Johns Hopkins, DC. Interested in voice & swallow outcomes after surgery

[Vaninder Dhillon @VaninderD]

#ahnschat Thank you to all of our patients, and for the questions tonight!

[Vaninder Dhillon @VaninderD]

#ahnschat Look for a surgeon and a team who will commit to working with you as you navigate this terrain, and keep you informed, offer all options and provide guidance every step of the way

[Vaninder Dhillon @VaninderD]

#ahnschat We have been fortunate to evaluate responses with our ThyCa members of patients who have undergone recurrence. Having the support before, during and after thyroid cancer surgery and reoperative surgery is a lifelong commitment.

[Vaninder Dhillon @VaninderD]

@mcmullen_dr Yes! the patient-physician relationship with strong communication and offered resources for patients to feel educated and well informed is so important!

[Vaninder Dhillon @VaninderD]

#ahnschat A5. An experienced, trained endocrine surgeon who has not only experience in thyroid and parathyroid surgery, but reoperative thyroid cancer surgery (for recurrence). Also, a surgeon who works with a multidisciplinary team with other specialists in a high volume center

[Vaninder Dhillon @VaninderD]

#ahnschat patient preference is also very important, if this is a choice and the non surgical option can provide oncologic benefit!

[Vaninder Dhillon @VaninderD]

#ahnschat A4. additional surgery may not be a good idea for any patient with any co-morbidities or medical issues that doesn't allow them to undergo surgery, where the risks of surgery outweigh any benefit of providing increased survival.

[Vaninder Dhillon @VaninderD]

#ahnschat
'watch and wait' is supported by the guideline recommendations, but is dependent on each individual patient, their type of thyroid cancer and the location of their cancer. it is important as a patient to discuss this with your surgeon and team, including the pro/ con

[Vaninder Dhillon @VaninderD]

#ahnschat I am in agreement with Dr. Chen. Prior to any reoperative surgery it is important to confirm vocal fold mobility by directly looking at the vocal folds through a laryngoscopy or videostroboscopy in the office (camera examination)

[Vaninder Dhillon @VaninderD]

@zemkai @allenhomd Yes, @zemkai. In any type of surgery, whether for primary thyroid cancer or cancer, parathyroid glands can be 'autotransplanted' which means they can be reimplanted in another part of the part and still function as glands that irrespective of location can secrete hormone

[Vaninder Dhillon @VaninderD]

#ahnschat @elliebenya
Great question. good objective imaging like CT with contrast and ultrasound are my choice for guiding surgery for recurrence.

[Vaninder Dhillon @VaninderD]

@AHNSEndo Great to be here

[Vaninder Dhillon @VaninderD]

#ahnschat A1. Recurrent thyroid surgery is challenging given need to identify surgical landmarks altered by scar tissue. Strong imaging is important in preoperative planning

[Vaninder Dhillon @VaninderD]

Vaninder Dhillon, endocrine surgeon. Johns Hopkins University #ahnschat

[Vaninder Dhillon @VaninderD]

Thank you all for your answers. Very stimulating! And thank you to @ThyCaInc and #AHNSChat. Goodnight everyone.

[Vaninder Dhillon @VaninderD]

@AHNSEndo @PSkerl @ThyCaInc There is a paper within the voice literature on the benefits of early injection laryngoplasty.
https://t.co/UD2N8bE7Nx
#ahnschat

[Vaninder Dhillon @VaninderD]

A5. As a voice and swallow specialist as well as an endocrine surgeon, I am curious to know, for those who had nerve injury or voice concerns after surgery, how fast were you diagnosed, and treated.. #ahnschat

[Vaninder Dhillon @VaninderD]

@AHNSEndo @PSkerl @ThyCaInc I then see patients back within 6-8 weeks after injection, or within 4 weeks post op (if no injection) to follow up and see how they are improving. I'm an advocate for early injection (which fortunately I can do in office).

[Vaninder Dhillon @VaninderD]

@AHNSEndo @PSkerl @ThyCaInc If there is inherent knowledge that a vocal fold is paralyzed during surgery, I like to have patients seen speech therapy before discharge to prevent risk for aspiration. I see them back within 1-2 weeks and we plan on an in office injection if there is continued aspiration

[Vaninder Dhillon @VaninderD]

A7. Every patient should have a discussion with their surgeons as to whether it will add value to the surgery decision making process #ahnschat

[Vaninder Dhillon @VaninderD]

A7. Gene testing involves a host of assays, which all have different values in whether they help in ruling IN or OUT the risk for cancer. #ahnschat