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术中经皮喉超声评估甲状腺手术中声带功能。

Perioperative transcutaneous laryngeal ultrasonography to assess vocal cord function in thyroid surgery.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

出版信息

Am J Surg. 2022 May;223(5):893-899. doi: 10.1016/j.amjsurg.2021.08.019. Epub 2021 Aug 15.

Abstract

BACKGROUND

Early diagnosis of vocal cord iatrogenic injury is crucial, as is perioperative vocal cord evaluation.

METHODS

Vocal cord mobility detected via transcutaneous laryngeal ultrasonography was compared with that detected via laryngoscopy (the reference). The vocal cord visualization rate of ultrasonography for evaluation of mobility was explored.

RESULTS

The diagnostic odds ratio of transcutaneous laryngeal ultrasonography was 303.2212 (95% CI, [86.7944; 1059.3198]). The area under the summary receiver operating characteristic curve was 0.944. The sensitivity, specificity, and negative predictive value were 0.9154 [0.8471; 0.9548], 0.9771 [0.9541; 0.9887], and 0.9915 [0.9868; 0.9946], respectively. The vocal cord visualization of ultrasonography used to evaluate vocal cord mobility was high (0.9572 [0.9091; 0.9804]).

CONCLUSIONS

Since transcutaneous laryngeal ultrasonography has the advantage in vocal cord visualization, it can be considered when laryngoscopy is unavailable or patients refuse laryngoscopy. Also, it is diagnostically accurate regardless of the used landmarks, VCP definition, and timing for application.

摘要

背景

早期诊断声带医源性损伤至关重要,围手术期声带评估也是如此。

方法

通过经皮喉超声检查检测到的声带活动度与喉镜检查(参考标准)进行比较。探讨了超声评估声带活动度的声带可视化率。

结果

经皮喉超声检查的诊断优势比为 303.2212(95%CI,[86.7944; 1059.3198])。综合受试者工作特征曲线下面积为 0.944。敏感度、特异度和阴性预测值分别为 0.9154 [0.8471; 0.9548]、0.9771 [0.9541; 0.9887]和 0.9915 [0.9868; 0.9946]。用于评估声带活动度的超声检查的声带可视化率较高(0.9572 [0.9091; 0.9804])。

结论

由于经皮喉超声在声带可视化方面具有优势,因此在无法进行喉镜检查或患者拒绝喉镜检查时可以考虑使用。此外,无论使用的标志、VCP 定义和应用时间如何,其诊断准确性均较高。

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