PDF(Pubmed)
Abstract：
Unilateral vocal cord paralysis (UVCP) is a known complication of thyroid surgery, due to iatrogenic recurrent laryngeal nerve injury, with reported rates of 2%-5% in children. The gold standard for assessing vocal cord function in flexible nasendoscopy (FNE) examination, which is considered high-risk for contraction of the COVID-19 virus. Intraoperative ultrasonographic assessment (IUA) of vocal cord function is a non-invasive and relatively simple procedure performed in a supine position, performed during spontaneous breathing, following reversed anaesthesia, while the patient is still sedated.
To evaluate the validity of IUA modality in children undergoing thyroidectomy and to compare it to the standard FNE.
A prospective double-blind study covering 24 months (March 2019-March 2021). Twenty thyroid lobectomies were performed, during 15 surgeries. Vocal cord function was assessed three times: Pre-operatively by FNE, intraoperative (IUA) following extubation, and a second FNE on the first post-operative day.
A tertiary paediatric hospital.
The overall accuracy of IUA results in our study was 92%. IUA sensitivity, specificity, positive and negative predictive values were 100%, 89%, 33% and 100%, respectively. Patient\'s age demonstrated borderline significance (p = .08). The resident\'s experience was associated with a better correlation between IUA and FNE results (p < .05).
IUA of vocal cord motion has a high accuracy rate for detection of iatrogenic vocal cord paralysis, similar to FNE. It is easily learned by residents, well-tolerated by children, and it provides a safe and valid alternative modality while ensuring the safety of the medical staff in treating patients, especially in times of COVID-19 pandemic.
To evaluate the validity of IUA modality in children undergoing thyroidectomy and to compare it to the standard FNE.
A prospective double-blind study covering 24 months (March 2019-March 2021). Twenty thyroid lobectomies were performed, during 15 surgeries. Vocal cord function was assessed three times: Pre-operatively by FNE, intraoperative (IUA) following extubation, and a second FNE on the first post-operative day.
A tertiary paediatric hospital.
The overall accuracy of IUA results in our study was 92%. IUA sensitivity, specificity, positive and negative predictive values were 100%, 89%, 33% and 100%, respectively. Patient\'s age demonstrated borderline significance (p = .08). The resident\'s experience was associated with a better correlation between IUA and FNE results (p < .05).
IUA of vocal cord motion has a high accuracy rate for detection of iatrogenic vocal cord paralysis, similar to FNE. It is easily learned by residents, well-tolerated by children, and it provides a safe and valid alternative modality while ensuring the safety of the medical staff in treating patients, especially in times of COVID-19 pandemic.
摘要：
单侧声带麻痹（UVCP）是甲状腺手术的已知并发症，由于医源性喉返神经损伤，据报道，儿童发病率为2%-5%。在柔性鼻内镜（FNE）检查中评估声带功能的金标准，这被认为是COVID-19病毒收缩的高风险。声带功能的术中超声检查（IUA）是仰卧位进行的非侵入性且相对简单的程序，在自主呼吸期间进行，逆转麻醉后，病人还在镇静剂的时候.
评估IUA模式在接受甲状腺切除术的儿童中的有效性，并将其与标准FNE进行比较。
一项涵盖24个月（2019年3月至2021年3月）的前瞻性双盲研究。进行了20例甲状腺切除术,15次手术声带功能评估三次：术前通过FNE，术中（IUA）拔管后，和第二个FNE在手术后的第一天。
一家三级儿科医院。
我们研究中IUA结果的总体准确度为92%。IUA灵敏度，特异性，阳性和阴性预测值为100%，89%,33%和100%，分别。患者的年龄显示出临界显著性(p=.08)。居民的经验与IUA和FNE结果之间的相关性更好（p<0.05）。
声带运动的IUA对医源性声带麻痹的检测具有较高的准确率，类似于FNE。居民很容易学会，孩子们能很好地忍受，它提供了一种安全有效的替代方式，同时确保了医务人员治疗患者的安全，特别是在COVID-19大流行时期。
评估IUA模式在接受甲状腺切除术的儿童中的有效性，并将其与标准FNE进行比较。
一项涵盖24个月（2019年3月至2021年3月）的前瞻性双盲研究。进行了20例甲状腺切除术,15次手术声带功能评估三次：术前通过FNE，术中（IUA）拔管后，和第二个FNE在手术后的第一天。
一家三级儿科医院。
我们研究中IUA结果的总体准确度为92%。IUA灵敏度，特异性，阳性和阴性预测值为100%，89%,33%和100%，分别。患者的年龄显示出临界显著性(p=.08)。居民的经验与IUA和FNE结果之间的相关性更好（p<0.05）。
声带运动的IUA对医源性声带麻痹的检测具有较高的准确率，类似于FNE。居民很容易学会，孩子们能很好地忍受，它提供了一种安全有效的替代方式，同时确保了医务人员治疗患者的安全，特别是在COVID-19大流行时期。
