Использование чрескожной ультрасонографии гортани для оценки подвижности голосовых складок после выполнения оперативных вмешательств на щитовидной и околощитовидных железах

The amount of thyroid and parathyroid surgeries increases annually. Contemporary diagnostics of such a severe complication, as larynx paresis, remains nowadays actual. The main diagnostic procedure for larynx paresis is endoscopic laryngoscopy, though it has several disadvantages: this is an invasive procedure, causing discomfort to the patients, it requires local anesthesia, which may lead to allergy; some patients can’t endure this procedure because of the anatomical features. All these factors force to find out a similar and at the same time effective diagnostic procedure for revealing disturbances of vocal cords mobility. This work represents the experience of implementation of 1252 percutaneous ultrasound examination of the vocal cords. We showed the diagnostic efficiency and convenience of this method at the endocrine surgical department. Aim. To evaluate a possibility of percutaneous ultrasound examination for detection of vocal cords mobility after thyroid and parathyroid surgery comparing with the laryngoscopy. Materials and methods. The first stage of the work included 809 patients, who were subjected to percutaneous larynx ultrasound check-up. During the second stage 443 patients were examined before and after operative treatment by means of larynx ultrasound and endoscopic laryngoscopy. Results. It is possible to visualize vocal cords in 85.9% of patients: in case of female patients it is possible to visualize vocal cords in 90.6%, and in men in 27.9% (c 2 = 183.6; p < 0.001). The visualization of vocal cords is feasible in 97.4% of patients under 40 years and in 57.1% in patients over 80 years (c 2 = 42.4; p < 0.001). Diagnostic efficiency of ultrasound visualization of vocal cords abnormality appeared to be 91.4%.The sensitivity of the method reached 62.5%, specificity 95.3%. Diagnostic efficiency of ultrasound visualization of vocal cords paresis reached 97.7%. The increase of this index is caused by sensitivity growth, which was 88.2%. Specificity grew also upto 98.5%. Dependence of diagnostic efficiency of ultrasound examination of vocal cords abnormality and patients’ age was statistically significant (c 2 = 6.3; p < 0.05). Conclusions. Percutaneous ultrasound examination of vocal cords is effective and convenient method of control over larynx function in patients after thyroid and parathyroid surgery.