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World Journal of Surgery

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01-03-2016 | Original Scientific Report

Transcutaneous Ultrasonography in Early Postoperative Diagnosis of Vocal Cord Palsy After Total Thyroidectomy

Authors: Frédéric Borel, Anne-Sophie Delemazure, Florent Espitalier, Andrew Spiers, Eric Mirallie, Claire Blanchard

Published in: World Journal of Surgery | Issue 3/2016

Abstract

Purpose

This study evaluated the efficiency of transcutaneous laryngeal ultrasonography (TLUS) as an alternative to direct flexible laryngoscopy (DFL) in the early postoperative screening of vocal cord palsy (VCP) after total thyroidectomy, performed for benign and non-extensive malignant disease.

Methods

A prospective study was performed on patients who underwent total thyroidectomy between October 2013 and January 2015 at the Nantes University Hospital (France). Patients underwent DFL on postoperative day 1 performed by an otolaryngologist, followed by TLUS performed by a radiologist on postoperative day 1 or 2.

Results

One hundred and three (103) patients were included in this study, 17.5 % were male and 82.5 % were female, with a mean age of 51 ± 12 years. Nine patients (9.5 %) were diagnosed with postoperative VCP using DFL of these cases 2 were not completely resolved at 3 months postoperatively. Three cases of VCP (33 %) were diagnosed using TLUS. TLUS had a sensitivity of 33 % and a negative predictive value (NPV) of 95 % for the diagnosis of postoperative VCP. Vocal cords (VC) were unassessable in 27.2 % of patients. Unassessable VC were significantly associated with male gender (p = 0.0001), age (p = 0.0001), weight (p = 0.002), operating time (p = 0.032), postoperative drainage (p = 0.001), and thyroid weight (p = 0.001). Independent risk factors in the multivariate analysis were male gender (p = 0.0001) and age (p = 0.0001). In the group of women under 50-year old, TLUS had a sensitivity of 50 % and a NPV of 97.4 %.

Conclusion

TLUS sensitivity is insufficient in early postoperative screening of VCP after thyroid surgery. Ultrasonographic VCP diagnosis should be confirmed with DFL.

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Title: Transcutaneous Ultrasonography in Early Postoperative Diagnosis of Vocal Cord Palsy After Total Thyroidectomy
Authors: Frédéric Borel
Anne-Sophie Delemazure
Florent Espitalier
Andrew Spiers
Eric Mirallie
Claire Blanchard
Publication date: 01-03-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 3/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-015-3393-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transcutaneous Ultrasonography in Early Postoperative Diagnosis of Vocal Cord Palsy After Total Thyroidectomy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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