...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >The utility of evaluating true vocal fold motion before thyroid surgery.
【24h】

The utility of evaluating true vocal fold motion before thyroid surgery.

机译：在甲状腺手术前评估真实声带运动的实用程序。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: The objective of this study was to evaluate the utility of screening laryngoscopic examination in evaluating vocal fold (VF) mobility before thyroid surgery. METHODS: The authors conducted a retrospective chart review of 340 patients who have undergone thyroid surgery from January 1998 to June 2005 and had preoperative laryngoscopy by mirror, fiberoptic, or videostroboscopic examination. Reports of preoperative voice change or complaint and reports of preoperative VF examination, including the method of examination, were recorded. For patients with VF motion impairment, reports of the intraoperative condition of the recurrent laryngeal nerve (RLN), preoperative diagnosis based on fine needle aspiration, and final postoperative histopathologic examination results were recorded. RESULTS: Twenty-two patients were found to have preoperative VF motion impairment, of which seven (32%) patients were asymptomatic with no detectable subjective or objective voice problems. This differs significantly from the hypothesis that patients with VF motion impairment are always symptomatic (P=.009). Using voice symptoms as a screening test to predict VF motion impairment in 340 patients reveals that the sensitivity was 68%, specificity was 91%, positive predictive value (PPV) was 31%, and negative predictive value (NPV) was 98%. Among the 22 patients with preoperative VF motion impairment, five (72%) of the seven asymptomatic patients had benign, slowly progressive disease on their final histopathology reports. Six of these asymptomatic patients had their preoperative VF evaluation by fiberoptic examination, whereas one patient had indirect mirror laryngoscopy. Of 22 patients with preoperative VF motion impairment, five (22.5%) patients had abnormal VF mobility contralateral to the thyroid lesion on their preoperative evaluation, and only two of them had nerve injury reported after a previous thyroid surgery. This result differs significantly from the hypothesis that impaired mobility is ipsilateral to the side of the lesion (P=.05). CONCLUSIONS: Patients without voice complaints can have VF motion impairment. Patients can also have VF motion impairment contralateral to the thyroid lesion. Preoperative VF examination helps counsel patients appropriately about the risks of surgery and helps outline a plan for the extent of surgery while minimizing the medicolegal ramifications of iatrogenic RLN injury.
机译：目的：本研究的目的是评估筛查喉镜检查在评估甲状腺手术前声带（VF）活动性方面的实用性。方法：作者回顾性分析了1998年1月至2005年6月间接受甲状腺手术并通过镜检，纤维镜或视频频闪检查进行术前喉镜检查的340例患者的病历。记录术前声音变化或抱怨的报告以及术前室颤检查的报告，包括检查方法。对于VF运动障碍的患者，记录了喉返神经（RLN）的术中情况，基于细针穿刺的术前诊断以及最终的术后组织病理学检查结果的报告。结果：发现22例术前VF运动障碍，其中7例（32％）无症状，没有可检测到的主观或客观语音问题。这与VF运动障碍患者总是有症状的假说有显着差异（P = .009）。使用语音症状作为筛查测试来预测340例患者的VF运动障碍，发现其敏感性为68％，特异性为91％，阳性预测值（PPV）为31％，阴性预测值（NPV）为98％。在22名术前VF运动障碍患者中，有7名无症状患者中有5名（72％）在其最终的组织病理学报告中患有良性缓慢进展的疾病。这些无症状患者中有6名通过光纤检查进行了术前VF评估，而1名患者进行了间接镜喉镜检查。在22例术前VF运动障碍的患者中，有5例（22.5％）的患者在术前评估中与甲状腺病变对侧的VF活动性异常，并且只有2例在先前的甲状腺手术后有神经损伤的报道。该结果与假想的移动性与病变侧同侧的假设有显着差异（P = .05）。结论：无声音抱怨的患者可有室颤运动障碍。患者还可能在甲状腺病变对侧发生室颤运动障碍。术前VF检查有助于适当地为患者提供手术风险的咨询，并帮助制定手术计划，同时最大程度地减少医源性RLN损伤的法医后果。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号