ULTRASOUND INVESTIGATION DIAGNOSTIC POTENTIAL IN LARYNGEAL SOFT TISSUE CONDITION DETERMINATION AND VOCAL APPARATUS DISORDERS AFTER THYROID SURGERY

Authors:

Abstract:

The purpose of the study was to assess the clinical reasonability of laryngeal organs ultrasound examination to recognize complications or transient functional disorders occurring after the neck organs surgical operations. 12 patients with disorders of phonation, swallowing and breathing after neck organs surgery were under observation. 12 practically healthy individuals without pathological changes in neck organs consisted the control group. The “Kontron” ultrasound system for all patients’ larynx and neighboring soft tissues ultrasound examination in static and dynamic modes was used to objectify the clinical symptoms during the 7-day period after the operation. The data obtained allowed us to consider the technique of thyroid tissue ultrasound examination as the most sensitive tool for diagnosing possible lesions of its parenchyma and laryngeal organs functions. The method of ultrasound investigation was shown to be an appropriate and objective tool of laryngeal organs condition and functional disorders postoperative monitoring. Postoperative ultrasound examination of the larynx is a means of differential diagnosis between recurrent laryngeal nerve mechanical damage and functional transient disorders associated with laryngeal mucosa edema. The authors suppose that combined use of larynx ultrasound with commonly used means of direct and indirect laryngoscopy increases the reliability of laryngeal functions probable disorders differential diagnosis and allows for more rational determination of prognostic criteria and further treatment tactics.

Keywords:

thyroid gland neck surgical operations larynx vocal apparatus phonation disorders ultrasound examination diagnostics

References:

1. Klymenko MO. Nyzkostupeneve dyfuzne khronichne zapalennya. Aktualni problemy transportnoyi medytsyny. 2022; 3(69): 7-19. doi: http://dx.doi.org/10.5281/zenodo.7188166. [in Ukrainian].
2. Barczyński M, Randolph GW, Cernea C, International Neural Monitoring Study Group in Thyroid and Parathyroid Surgery. International survey on the identification and neural monitoring of the EBSLN during thyroidectomy. Laryngoscope. 2016; 126(1): 285-291. doi: 10.1002/lary.25548.
3. Beka E, Gimm O. Voice Changes Without Laryngeal Nerve Alterations After Thyroidectomy: The Need For Prospective Trials - A Review Study. J Voice. 2024; 38(1): 231-238. doi: 10.1016/j.jvoice.2021.07.012.
4. Cheruiyot I, Kipkorir V, Henry BM, Munguti J, Cirocchi R, Odula P. et al. Surgical anatomy of the external branch of the superior laryngeal nerve: A systematic review and meta-analysis. Langenbecks Arch Surg. 2018; 403(7): 811-823. doi: 10.1007/s00423-018-1723-9.
5. Cirocchi R, Arezzo A, D’Andrea V, Abraha I, Popivanov GI, Avenia N. et al. Intraoperative neuromonitoring versus visual nerve identification for prevention of recurrent laryngeal nerve injury in adults undergoing thyroid surgery. Cochrane Database Syst Rev. 2019; 1(1): CD012483. doi: 10.1002/14651858.CD012483.pub2.
6. Freilinger A, Kaserer K, Zettinig G, Pruidze P, Reissig LF, Rossmann T. et al. Ultrasound for the detection of the pyramidal lobe of the thyroid gland. J Endocrinol Invest. 2022; 45(6): 1201-1208. doi: 10.1007/s40618-022-01748-z
7. Gan T, Randle RW. The Role of Surgery in Autoimmune Conditions of the Thyroid. Surg Clin North Am. 2019; 99(4): 633-648. doi: 10.1016/j.suc.2019.04.005.
8. Głód M, Marciniak D, Kaliszewski K, Sutkowski K, Rudnicki J, Bolanowski M. et al. Analysis of Risk Factors for Phonation Disorders after Thyroid Surgery. Biomedicines. 2022; 10(9): 2280. doi: 10.3390/biomedicines10092280.
9. Joliat GR, Guarnero V, Demartines N, Schweizer V, Matter M. Recurrent laryngeal nerve injury after thyroid and parathyroid surgery: Incidence and postoperative evolution assessment. Medicine (Baltimore). 2017; 96(17): 6674. doi: 10.1097/MD.0000000000006674.
10. Macvanin MT, Gluvic ZM, Zaric BL, Essack M, Gao X, Isenovic ER. New biomarkers: prospect for diagnosis and monitoring of thyroid disease. Front Endocrinol (Lausanne). 2023; 14: 1218320. doi: 10.3389/fendo.2023.1218320.
11. Oscé H, Magamadov K, Van Den Heede K, Brusselaers N, Vermeersch H, Van Slycke S. Intra-operative recovery of preoperative vocal cord paralysis during hemithyroidectomy for benign thyroid disease: case report and review of the literature. Acta Chir Belg. 2021; 121(3): 215-218. doi: 10.1080/00015458.2019.1675973.
12. Rybakovas A, Bausys A, Matulevicius A, Zaldokas G, Kvietkauskas M, Tamulevicius G. et al. Recurrent laryngeal nerve injury assessment by intraoperative laryngeal ultrasonography: a prospective diagnostic test accuracy study. Wideochir Inne Tech Maloinwazyjne. 2019; 14(1): 38-45. doi: 10.5114/wiitm.2018.80066.
13. Stopa M, Barczyński M. Prognostic value of intraoperative neural monitoring of the recurrent laryngeal nerve in thyroid surgery. Langenbecks Arch Surg. 2017; 402(6): 957-964. doi: 10.1007/s00423-016-1441-0.
14. Uludağ M, Tanal M, İşgör A. A Review of Methods for the Preservation of Laryngeal Nerves During Thyroidectomy. Sisli Etfal Hastan Tip Bul. 2018; 52(2): 79-91. doi: 10.14744/SEMB.2018.37928.
15. Vastyanov RS, Stoyanov OM, Babienko VV, Hruzevskiy OA, Talalayev KO, Kirchev VV. et al. Plasma rich platelets anti-inflammatory effect in conditions of carrageenan-induced paw edema in rats. World of Medicine and Biology. 2024; 4(90): 170-175. doi: 10.26724/2079-8334-2024-4-90-170-175.

Publication:

«World of Medicine and Biology» Vol. 21 No. 91 (2025) , с. 32-36
УДК 616.441-006.2-073.48

DOI:

https://doi.org/10.26724/2079-8334-2025-1-91-32-36