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Neck Ultrasound (neck + ultrasound)

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Medical Sciences100%

Selected Abstracts

Neck ultrasound for prediction of right nonrecurrent laryngeal nerve

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2010
Shih-Ming Huang MD
Abstract Background. Nonrecurrent laryngeal nerve (NRLN) is 1 of the important causes for nerve damage during neck surgery. The anomaly is almost associated with congenital vascular abnormally. Most neck vascular anomalies can be detected by ultrasound. Methods. Both 3.5-MHz and 10-MHz probe neck ultrasound scans were performed for 2330 patients undergoing thyroidectomy preoperatively. Absence of innominate artery (INA) was defined as positive with right NRLN. Results. Of 13 positive patients found by 10-MHz probe, 11 were also identified by 3.5-MHz probe, and proved to be with right NRLN during operation. Two false-positive patients (18%) found by 10-MHz probe were due to short INA and tortuous INA, respectively. The incidence of right NRLN was 0.47% in Chinese people. Both the sensitivity and specificity for predicting right NRLN by 3.5-MHz probe were 100%. Conclusion. A 3.5-MHz probe neck ultrasound scan can accurately demonstrate right NRLN. Applying this tool for neck surgery to reduce the nerve damage is highly advised. © 2009 Wiley Periodicals, Inc. Head Neck, 2010 [source]

Recombinant human TSH testing is a valuable tool for differential diagnosis of congenital hypothyroidism during l -thyroxine replacement

CLINICAL ENDOCRINOLOGY, Issue 2 2003
Laura Fugazzola
Summary objective The differential diagnosis of congenital hypothyroidism (CH) is aimed to distinguish transitory from permanent forms, to optimize l-thyroxine (l-T4) therapy to replacement or TSH-suppressive regimens, and to reach accurate definition of the clinical and biochemical phenotype for subsequent genetic investigations and counselling. Therefore, l -T4 therapy is presently withdrawn in most instances and investigations are performed in a disturbing hypothyroid state. design The availability of recombinant human TSH (rhTSH) prompted us to assess its efficacy in the differential diagnosis of CH during l-T4 therapy. patients and measurements Eight adult patients with permanent CH remained on l -thyroxine and underwent a new protocol for rhTSH (Thyrogen®) testing with injections [4 g/kg/day intramuscularly (i.m.)] at days 1, 2 and 3. At day 3, 123I was administered and uptake obtained after 2 and 24 h. Serum TSH and thyroglobulin (Tg) levels were measured at days 1,4. Neck ultrasound was carried out in all cases. results Serum TSH reached levels > 20 mU/l at day 2 and remained above 30 mU/l on days 3 and 4. Stimulation of Tg levels was seen in five patients with peak at day 4. Lingual thyroid was documented at scintigraphy (TS) in three Tg-responsive patients who were previously diagnosed as having thyroid agenesia. In one patient with dyshormonogenesis and high Tg, TS confirmed the presence of goitre with positive perchlorate test. TS was negative in the remaining four cases. All tests indicated complete agenesia in one, whereas a minimal Tg response was marker of nearly complete agenesia in another. The last two TS-negative patients had hypoplastic glands at ultrasound, and refractoriness to TSH stimulation was confirmed by absent Tg response. conclusions We report the first application of rhTSH for differential diagnosis of patients with permanent CH, avoiding the undesirable transient hypothyroidism consequent to l-T4 withdrawal. The data obtained led to the change of the diagnosis at presentation in 4/8 patients and to a more accurate description of the clinical picture in all patients. The proposed protocol has been proved to cause Tg increases even in the presence of small amounts of responsive thyroid cells. The rhTSH testing led to the desired disease characterization, thus allowing specific management and targeted genetic analyses. [source]

Neck ultrasound for prediction of right nonrecurrent laryngeal nerve

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2010
Shih-Ming Huang MD
Abstract Background. Nonrecurrent laryngeal nerve (NRLN) is 1 of the important causes for nerve damage during neck surgery. The anomaly is almost associated with congenital vascular abnormally. Most neck vascular anomalies can be detected by ultrasound. Methods. Both 3.5-MHz and 10-MHz probe neck ultrasound scans were performed for 2330 patients undergoing thyroidectomy preoperatively. Absence of innominate artery (INA) was defined as positive with right NRLN. Results. Of 13 positive patients found by 10-MHz probe, 11 were also identified by 3.5-MHz probe, and proved to be with right NRLN during operation. Two false-positive patients (18%) found by 10-MHz probe were due to short INA and tortuous INA, respectively. The incidence of right NRLN was 0.47% in Chinese people. Both the sensitivity and specificity for predicting right NRLN by 3.5-MHz probe were 100%. Conclusion. A 3.5-MHz probe neck ultrasound scan can accurately demonstrate right NRLN. Applying this tool for neck surgery to reduce the nerve damage is highly advised. © 2009 Wiley Periodicals, Inc. Head Neck, 2010 [source]

ORIGINAL ARTICLE: Accuracy of surface landmark identification for cannula cricothyroidotomy

ANAESTHESIA, Issue 9 2010
D. S. J. Elliott
Summary Cannula cricothyroidotomy is recommended for emergency transtracheal ventilation by all current airway guidelines. Success with this technique depends on the accurate and rapid identification of percutaneous anatomical landmarks. Six healthy subjects underwent neck ultrasound to delineate the borders of the cricothyroid membrane. The midline and bisecting transverse planes through the membrane were marked with an invisible ink pen which could be revealed with an ultraviolet light. Eighteen anaesthetists were then invited to mark an entry point for cricothyroid membrane puncture. Only 32 (30%) attempts by anaesthetists accurately marked the skin area over the cricothyroid membrane. Of these only 11 (10%) marked over the centre point of the membrane. Entry point accuracy was not significantly affected by subjects' weight, height, body mass index, neck circumference or cricothyroid dimensions. Consultant and registrar anaesthetists were significantly more accurate than senior house officers at correctly identifying the cricothyroid membrane. Accuracy of percutaneously identifying the cricothyroid membrane was poor. Ultrasound may assist in identifying anatomical landmarks for cricothyroidotomy. [source]