甲状腺结节热消融术后的嗓音结局：一项系统评价。
Voice Outcomes Following Thermal Ablation for Thyroid Nodules: A Systematic Review.
文献信息
| PMID | 42852797 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Stavroula Mouratidou |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK. |
| 期刊 | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 评估甲状腺良恶性结节热消融治疗后的嗓音结局。
数据来源： 对PubMed和Embase数据库进行了截至2025年3月的系统性文献综述。
综述方法： 本系统评价按照系统评价和荟萃分析首选报告项目（PRISMA）指南进行。纳入标准为接受甲状腺结节热消融治疗并报告客观嗓音结局的成年患者研究。提取的数据包括研究特征、患者人口统计学、消融方式以及客观和主观嗓音结局。
结果： 共纳入18项研究，包含5168例患者。消融方式包括射频消融、微波消融、激光消融和高强度聚焦超声。使用纤维鼻内镜或超声评估对声带功能进行客观术前评估的报告见于2054例患者（39.7%）。术后客观声带评估最常在出现症状的病例中进行，而不论症状如何常规进行评估的有2110例患者（40.8%）。术后声带麻痹的合并发生率为1.4%，大多数病例为一过性。永久性声带麻痹罕见（n=2，0.05%）。无客观声带功能障碍的主观嗓音症状通常轻微且自限。
结论： 甲状腺结节热消融与临床显著嗓音并发症的低风险相关。大多数嗓音变化为一过性，尽管缺乏标准化嗓音评估可能低估了真实并发症发生率。常规客观喉部评估和标准化报告对于确保准确检测嗓音并发症、优化患者咨询以及提高甲状腺消融实践的安全性至关重要。
英文摘要
OBJECTIVE: To evaluate voice outcomes following thermal ablation techniques for the management of benign and malignant thyroid nodules.
DATA SOURCES: A systematic literature review of PubMed and Embase databases was performed up to March 2025.
REVIEW METHODS: This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Inclusion criteria were studies with adult patients undergoing thermal ablation for thyroid nodules with reported objective voice outcomes. Data extracted included study characteristics, patient demographics, ablation modality, and objective and subjective voice outcomes.
RESULTS: Eighteen studies comprising 5168 patients were included. Ablation modalities were radiofrequency ablation, microwave ablation, laser ablation, and high-intensity focused ultrasound. Objective pre-procedural assessment of vocal cord function using fibreoptic nasoendoscopy or sonographic evaluation was reported in 2054 patients (39.7%). Post-procedural objective vocal cord assessment was most commonly performed in symptomatic cases, while assessment was routinely performed irrespective of symptoms in 2110 patients (40.8%). The pooled post-procedural vocal cord palsy rate was 1.4%, with most cases being transient. Permanent vocal cord palsy was rare (n = 2, 0.05%). Subjective voice symptoms without objective vocal cord dysfunction were generally mild and self-limiting.
CONCLUSION: Thermal ablation of thyroid nodules is associated with a low risk of clinically significant voice complications. Most voice changes are transient, although the lack of standardized voice assessment likely underestimates true complication rates. Routine objective laryngeal evaluation and standardized reporting are essential to ensure accurate detection of voice complications, optimize patient counseling, and enhance the safety of thyroid ablation practice.