[Value of preoperative diagnosis in struma surgery]

To determine the usefulness of so-called routine diagnostic procedures prior to thyroid operations, in 2007 consecutive patients undergoing thyroid surgery from 1976 until 1991, the results of 1833 scintigraphy examinations, 1358 tracheal X-rays, 773 ultrasound examinations, 302 fine-needle aspiration biopsies (FNAB), and 73 frozen sections (FS) performed during operation were evaluated. Scintigraphy and ultrasound showed similar positive predictive values, ranging between 85% and 95%, in detecting thyroid nodules. The sensitivity of FNAB and FS were 44% and 83%, respectively. Mechanical alteration of the trachea was found to correlate to a high degree with severe postoperative respiratory disorders, requiring prolonged ventilation or tracheotomy either during primary surgery or as a secondary procedure.