甲状腺切除术后出现的延迟发作的声带,尽管最初的术后内镜检查正常
Tianrui Ren1, Stephanie Manning1, James C Lee1,2
1Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia.
ANZ journal of surgery
|October 7, 2024
概括
甲状腺切除术后的延迟发作的声带是罕见的,但即使在正常的神经监测下也会发生. 大多数患者在六个月内恢复声功能,使用保守的管理和语音治疗.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 内分泌学 在内分泌学.
- 手术并发症 手术并发症
背景情况:
- 喉神经 (RLN) 重复损伤是甲状腺切除术的已知并发症.
- 延迟发作的声带是一种罕见的表现,尽管正常的手术内监测和初步的术后评估.
- 这种并发症可能会引起患者严重的痛苦,需要识别其发生率和预后.
研究的目的:
- 在甲状腺切除术后报告了澳大利亚第一个延迟发作的声带的系列.
- 探索这种罕见并发症的预后,病理生理机制和恢复时间框架.
- 帮助识别延迟发作的声带,安慰受影响的患者,并指导早期干预以改善生活质量.
主要方法:
- 回顾七名患有延迟发作的RLN的甲状腺切除术后病例系列.
- 所有患者都接受了正常的手术前和手术后的灵活鼻内镜 (FNE) 和手术内神经监测.
- 通过内镜证实了诊断,并进行了连续的FNE检查以监测康复. 使用了保守的管理方法,包括语音治疗.
主要成果:
- 七名患者 (43%男性,中位年龄65岁) 在手术后12天的中位数出现延迟发作的RLN.
- 在86%的病例中,并发症单方面发生.
- 所有患者的声带功能均在24周内恢复,其中86%的患者在六个月内恢复. 发生率为0.1%.
结论:
- 延迟发作的声带是甲状腺切除术的罕见但明显的并发症.
- 预后通常是有利的,大多数患者通过保守的管理和语音疗法实现功能恢复.
- 识别和理解这种情况对于患者的安慰和及时干预至关重要.
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