目的:声带活动度评估对甲状腺手术患者至关重要。我们旨在评估外科医生进行的经皮喉部超声(TLUS)与柔性鼻喉镜检查相比的可行性和有效性。
方法:从2022年2月至2022年12月,我们对计划在我们机构进行甲状腺全切除术的患者进行了一项前瞻性观察性研究。所有患者均接受TLUS检查,然后由双盲耳鼻喉科医生进行柔性鼻喉镜检查。将发现分为正常或声带运动障碍,然后进行比较。在TLUS上可评估的患者包括在A组,而那些不可评估的被包括在B组,并对其特征进行了比较。
结果:A组包括180名患者,而B组包括21例患者。男性(p<0.001),年龄(p=0.034),BMI(p<0.001),甲状腺体积(p=0.038),和颈围(p<0.001)与B组相关。特异性,正预测值,负预测值,100%的准确度,99.4%,94.4%,100%,99.4%,分别。科恩的K值为0.984。
结论:TLUS是有效的,易于执行,非侵入性,和无痛的替代方法,用于评估选定患者的声带。它既可以用作一级检查,也可以用作选择柔性鼻喉镜检查病例的筛选工具。甲状腺常规超声检查中应结合TLUS。
OBJECTIVE: Assessing vocal cord mobility is crucial for patients undergoing thyroid surgery. We aimed to evaluate the feasibility and efficacy of surgeon-performed transcutaneous laryngeal ultrasound (TLUS) compared to flexible nasolaryngoscopy.
METHODS: From February 2022 to December 2022, we conducted a prospective observational study on patients scheduled for total thyroidectomy at our Institution. All patients underwent TLUS followed by flexible nasolaryngoscopy by a blinded otolaryngologist. Findings were classified as normal or vocal cord movement impairment and then compared. Patients evaluable on TLUS were included in Group A, while those not evaluable were included in Group B, and their features were compared.
RESULTS: Group A included 180 patients, while Group B included 21 patients. Male sex (p < 0.001), age (p = 0.034), BMI (p < 0.001), thyroid volume (p = 0.038), and neck circumference (p < 0.001) were associated with Group B. TLUS showed a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 99.4%, 94.4%, 100%, and 99.4%, respectively. Cohen\'s K value was 0.984.
CONCLUSIONS: TLUS is a valid, easy-to-perform, non-invasive, and painless alternative for evaluating vocal cords in selected patients. It can be used either as a first level exam and as screening tool for selecting cases for flexible nasolaryngoscopy. TLUS should be integrated into routine thyroid ultrasound examination.