甲状腺癌中喉返神经的超声检查：临床应用进展与研究进展

文献信息

中文摘要

甲状腺癌发病率和检出率的上升导致每年甲状腺切除术数量相应增加。在术后并发症中，喉返神经损伤（RLNI）仍然是影响患者生活质量的主要因素。为了追求精准治疗策略和降低神经损伤率，临床医生对喉返神经（RLN）表现出越来越大的兴趣。近年来，高频超声（HFUS）越来越多地被纳入甲状腺切除术的围手术期管理。本研究首次探讨甲状腺癌围手术期RLN管理。系统综述了RLN的超声特征，特别强调HFUS在术前筛查、术中监测和术后随访中的临床效用。我们还讨论了该技术的固有局限性并概述了未来方向。尽管取得了这些有希望的进展，但在确保不同患者群体中超声检查的准确性和标准化方面仍存在重大挑战。总之，本综述强调了HFUS在优化甲状腺癌围手术期神经监测和功能评估方面的变革潜力。然而，它也指出超声目前不能取代喉镜检查或术中神经监测（IONM），尽管它作为一种具有明确临床效用的有价值的补充工具。

英文摘要

The rising incidence and detection rate of thyroid cancer have led to a concomitant increase in the number of thyroidectomy procedures performed annually. Among the postoperative complications, recurrent laryngeal nerve injury (RLNI) remains a major factor affecting patients' quality of life. In pursuit of precision therapeutic strategies and reduced nerve injury rates,clinicians have shown growing interest in the recurrent laryngeal nerve(RLN). In recent years, high-frequency ultrasound (HFUS) has been increasingly incorporated into the perioperative management of thyroidectomy. This study is the first to address RLN management during the perioperative period for thyroid cancer. The ultrasonographic characteristics of the RLN are systematically reviewed, with particular emphasis on the clinical utility of HFUS in preoperative screening, intraoperative monitoring, and postoperative follow-up. We also discuss the inherent limitations of this technique and outline future directions. Despite these promising advances, significant challenges persist in ensuring the accuracy and standardization of ultrasonographic examinations across diverse patient populations. In conclusion, this review highlights the transformative potential of HFUS in optimizing perioperative neural monitoring and functional evaluation for thyroid cancer. However, it also notes that ultrasound cannot currently replace laryngoscopy or intraoperative nerve monitoring (IONM), though it serves as a valuable complementary tool with clear clinical utility.