| Objective: To study the diagnostic value of ultrasound vocal cord movement parameters measurement in predicting recurrent laryngeal nerve injury after thyroid surgery,and to provide a new perspective and method for clinical laryngoscopy examination after thyroid surgery.Research method: 167 normal individuals were selected to measure the angle and maximum movement of the vocal cords.48 patients after thyroid ablation and 30 patients after thyroid surgery were selected to measure the maximum movement and angle of the vocal cords.The vocal cords were measured under normal conditions,after thyroid ablation,and after thyroid surgery,respectively,and the movement of the vocal cords was recorded,Evaluate the diagnostic value of vocal cord ultrasound motion related parameters in predicting recurrent laryngeal nerve injury after thyroid surgery.Result:(1)We selected 167 normal individuals for vocal cord measurement,with an average left vocal cord angle of(29.91 ± 1.45)° and a right vocal cord angle of(30.06 ±1.61)°;The average maximum movement of the left vocal cord was(7.18 ± 0.26)mm,while the average maximum movement of the right vocal cord was(7.20 ± 0.28)mm.There was no statistical difference between the two sides(p>0.05).In addition,there were no statistically significant differences in the angle and maximum movement of the vocal cords in healthy individuals in terms of gender,age,etc.(p>0.05).(2)Selecting 48 patients after thyroid ablation,it was found through measurement data that the average maximum movement of the affected vocal cord on the day before ablation was(7.28 ±0.19)mm,the average maximum movement of the affected vocal cord on the week after surgery was(7.06 ± 0.22)mm,and the average maximum movement of the affected vocal cord on the month after surgery was(7.24 ± 0.25)mm.The maximum movement of the affected vocal cords one week after surgery was significantly reduced compared to the day before surgery(P<0.01)and one month after surgery(P<0.01),with statistically significant differences.The average angle of the affected vocal cord on the day before surgery was(29.13 ± 1.25)°,the average angle of the affected vocal cord on the week after surgery was(26.48 ± 1.81)°,and the average angle of the affected vocal cord on the month after surgery was(28.75 ± 1.77)°.The angle of the affected vocal cord in the first week after surgery was significantly reduced compared to the day before surgery(P<0.01)and the month after surgery(P<0.01),and the difference was statistically significant.(3)We selected 30 patients with Recurrent laryngeal nerve injury who underwent laryngoscopy after thyroid surgery.First,we measured and compared the maximum movement and angle of vocal cords on the affected side and the healthy side.The data showed that the angle of vocal cords on the affected side was(21.97 ± 1.47)° less than that on the healthy side(29.73 ± 1.84)°,with a statistically significant difference(t=25.09,P<0.01);The maximum movement of the affected vocal cord(4.87 ± 0.39)mm was smaller than that of the healthy vocal cord(6.99 ± 0.36)mm,with a statistically significant difference(t=29.87,P<0.01).The Receiver operating characteristic shows that the recommended critical value of ultrasonic measurement of vocal cord angle is 25.9,the sensitivity is 96.7%,and the specificity is 83.4%;The recommended threshold for maximum vocal cord movement is 6.03,with a sensitivity of 83.3% and a specificity of76.6%.It shows that the ultrasonic measurement indexes have diagnostic value in predicting Recurrent laryngeal nerve injury.Conclusion:In summary,ultrasound can effectively display various structures of the vocal cords.We have also conducted numerical measurements of the basic structure of the vocal cord ultrasound and established preliminary quantitative indicators for normal vocal cords.One week after thyroid ablation and in patients with Recurrent laryngeal nerve injury after thyroid surgery,the vocal cord measurement values of the affected side have significantly changed,indicating that the measurement of vocal cord movement line related parameters by ultrasound can have diagnostic value for predicting Recurrent laryngeal nerve injury,which has brought new examination methods for patients who are not suitable for laryngoscopy.We believe that vocal cord ultrasound examination in the future should be more and more widely used. |
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