Endocrinology and Nutrition Service, Hospital Moisès Broggi, Saint Joan Despi, Barcelona, Spain.
Eur J Endocrinol. 2010 Oct;163(4):665-9. doi: 10.1530/EJE-10-0235. Epub 2010 Aug 5.
In about 16-85% of subjects with goiter, upper airway obstruction (UAO) is observed. This percentage is higher in patients affected by goiter with endothoracic enlargement. UAO is an indication for surgery. Visual analysis of flow-volume loops (FVL) are the best indicators for UAO, although various studies using clinical and radiological parameters have observed no correlation.
To evaluate the presence of UAO in patients with endothoracic goiter enlargement and the relationship between the FVL with the observed symptoms and the measurements obtained by computed tomography (CT).
Subjects with endothoracic goiter enlargement participated in the study.
i) Symptom questionnaire (dysphagia, dyspnea, cough, oppression, dysphonia, and worsened symptoms when prone); ii) analysis: TSH and free thyroxine; iii) cervical ultrasound; iv) cervical-thoracic CT (measurements of area and diameter in the area of maximum stenosis and at 2 cm from the carina); v) chest radiography and vi) forced spirometry: visual analysis of FVL morphology and the maximum forced expiratory volume in 1 s (FEV(1)), forced expiratory flow at 50% vital capacity/forced inspiratory flow at 50% vital capacity and FEV(1)/peak expiratory flow parameters.
Fifty subjects participated in the study: 11 men/39 women, median age 73.8 years (43.76-88.43). UAO was diagnosed in 13 cases (26%, confidence interval: 14.6-40.3%) and 27 subjects (54%) presented symptoms suggesting goiter compression. No clinical or radiological variables showed the presence of UAO.
The frequency of UAO in subjects affected by goiter with endothoracic enlargement was lower than that described for goiter patients, and there were no clinical or radiological indicators to establish its presence.
在约 16-85%的甲状腺肿患者中,观察到上呼吸道阻塞(UAO)。在患有胸廓内甲状腺肿的患者中,这一比例更高。UAO 是手术的指征。流量-容积环(FVL)的视觉分析是 UAO 的最佳指标,尽管使用临床和影像学参数的各种研究观察到它们之间没有相关性。
评估胸廓内甲状腺肿扩大患者中 UAO 的存在,以及 FVL 与观察到的症状和计算机断层扫描(CT)获得的测量值之间的关系。
胸廓内甲状腺肿扩大的受试者参加了这项研究。
i)症状问卷(吞咽困难、呼吸困难、咳嗽、压迫感、声音嘶哑和仰卧时症状加重);ii)分析:TSH 和游离甲状腺素;iii)颈超声;iv)颈胸 CT(在最大狭窄区域和隆突 2 cm 处测量面积和直径);v)胸部 X 光和 vi)用力肺活量:FVL 形态和第 1 秒用力呼气量(FEV1)的最大用力呼气量、用力肺活量 50%时的呼气流量/用力吸气流量 50%时的呼气流量和 FEV1/峰值呼气流量参数的视觉分析。
50 名受试者参加了这项研究:11 名男性/39 名女性,中位年龄 73.8 岁(43.76-88.43)。诊断为 UAO 的有 13 例(26%,置信区间:14.6-40.3%),27 例(54%)出现提示甲状腺肿压迫的症状。没有临床或影像学变量显示 UAO 的存在。
胸廓内甲状腺肿患者中 UAO 的发生率低于甲状腺肿患者,且没有临床或影像学指标可以确定其存在。