甲状舌管囊肿切除术前的检查
Investigation prior to thyroglossal duct cyst excision.
作者信息
Joseph J, Lim K, Ramsden J
机构信息
Northampton General Hospital NHS Trust, UK.
出版信息
Ann R Coll Surg Engl. 2012 Apr;94(3):181-4. doi: 10.1308/003588412X13171221589892.
INTRODUCTION
Investigation of the anterior midline neck lump has been debated over the years with little agreement on best practice. Thyroglossal duct cysts (TDCs) are the most common aetiology. A TDC may contain ectopic thyroid tissue, which may affect the decision to excise.
METHODS
A computerised survey was sent to a representative sample of UK-based ENT surgeons to determine current practice in investigation of presumed TDCs and the incidence of ectopic thyroid tissue.
RESULTS
Overall, 95% of those surveyed use ultrasonography, with 32% also arranging thyroid function tests. Fifteen per cent had encountered absent normal thyroid tissue in the presence of a midline neck swelling. In 64% of cases this represented the only functioning thyroid tissue. Thyroid function tests were normal in all but two cases.
CONCLUSIONS
The results show a significant change in practice over the last decade. All surgeons would arrange some form of investigation of a presumed TDC, with the vast majority using ultrasonography. Radioisotope scanning should only be used if the ultrasonography or thyroid function tests are abnormal. The incidence of ectopic thyroid tissue in this survey was higher than previously calculated, with a 0.17% prevalence of midline neck lumps representing the only functioning thyroid tissue.
引言
多年来，对于颈部前正中线肿块的检查一直存在争议，在最佳实践方面几乎没有达成共识。甲状舌管囊肿（TDC）是最常见的病因。甲状舌管囊肿可能含有异位甲状腺组织，这可能会影响切除的决策。
方法
向英国耳鼻喉科外科医生的代表性样本发送了一项计算机化调查，以确定目前对疑似甲状舌管囊肿的检查实践以及异位甲状腺组织的发生率。
结果
总体而言，95%的受访者使用超声检查，32%的人还安排了甲状腺功能测试。15%的人在颈部中线肿胀的情况下遇到过正常甲状腺组织缺失的情况。在64%的病例中，这代表了唯一有功能的甲状腺组织。除两例病例外，所有病例的甲状腺功能测试均正常。
结论
结果显示在过去十年中实践有了显著变化。所有外科医生都会对疑似甲状舌管囊肿进行某种形式的检查，绝大多数人使用超声检查。只有在超声检查或甲状腺功能测试异常时才应使用放射性同位素扫描。本次调查中异位甲状腺组织的发生率高于先前计算的结果，中线颈部肿块中代表唯一有功能甲状腺组织的患病率为0.17%。
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