根据最近的研究,经皮喉部超声在甲状腺手术前后声带评估中的作用

Sylwia Wolff, Adam Gałązka, M. Dedecjus
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引用次数: 3

摘要

经皮喉部超声(TLUS)已成为一种廉价、方便、新颖的声带(VF)评估方法。VF检查的金标准方法是喉镜检查。它需要耳鼻喉专科会诊和额外的设备。此外,喉镜检查会给患者带来痛苦,在新冠肺炎大流行期间,喉镜检查是一种高风险的气雾剂生产程序。本文的目的是回顾关于TLUS在VF评估中的作用的出版物。考虑的方面包括VF可见性、影响VF可见性的因素以及TLUS检查期间测量的不同变量。VFs在TLUS中的可见度在72.8%-100%之间。男性的发病率(17-100%)明显低于女性(83-100%)。除2位作者外,所有作者都得出结论,TLUS是一种可行的工具,可以替代喉镜检查来诊断VFs。肥胖、年龄、男性、身高、钙化的甲状腺和靠近甲状腺软骨的切口是无法进入声带的独立因素。VF位移速度(VFDV)是多普勒测量的最客观的参数,它与引起VF振动的波的速度成比例。VF麻痹后,该参数降低。Valsalva操作、低频换能器和不同的换能器位置可以改善USG上获得的图像。在大多数情况下,TLUS可以充分评估VFs的功能是否完整或是否发生了轻瘫/麻痹。它是无创和快速的,不增加额外的费用,并且可以作为甲状腺术前检查的一部分。TLUS通常是喉镜检查的一种方便的替代方法。
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Transcutaneous laryngeal ultrasonography in vocal fold assessment before and after thyroid surgery in light of recent studies
Transcutaneous laryngeal ultrasonography (TLUS) has become a cheap, convenient, and novel method in vocal fold (VF) assessment. The gold standard method of VF examination is laryngoscopy. It requires ear, nose, and throat specialist consultation and additional equipment. Moreover, laryngoscopy causes distress to patients, and during the COVID-19 pandemic it is a high-risk, aerosol-producing procedure. The aim of the paper was to review publications on the role of TLUS in VF evaluation. Considered aspects included VF visibility, factors affecting them, and different variables measured during TLUS examination. The visibility of VFs in TLUS ranged from 72.8 to 100%. Among men it was significantly lower (17-100%) in comparison to women (83-100%). All but 2 authors concluded that TLUS is a viable tool that can be an alternative to laryngoscopy in diagnosing VFs. Obesity, age, male gender, height, calcified thyroid, and incision close to the thyroid cartilage were independent factors for inaccessible vocal folds. VF displacement velocity (VFDV) is the most objective parameter measured by Doppler, and it is proportional to the velocity of the wave causing the vibrations of the VFs. After VF paralysis, this parameter is reduced. Valsalva manoeuvre, low-frequency transducer, and different transducer positions can improve images obtained on USG. TLUS in a majority of cases can adequately assess whether the function of the VFs is intact or paresis/paralysis has occurred. It is noninvasive and rapid, it adds no extra cost, and it can be a part of the preoperative examination of the thyroid gland. TLUS can usually be a convenient alternative to laryngoscopy.
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