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Do flow volume loops alter surgical management in patients with a goitre?
Author(s) -
Stevens J.L.,
Constantinides V.,
Todd J.,
Meeran K.,
Christakis I.,
Tolley N.S.,
Palazzo F.F.
Publication year - 2014
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12539
Subject(s) - medicine , airway obstruction , thyroid , radiology , surgery , airway
Summary Introduction Flow volume loops ( FVL s) are considered part of the workup of patients with thyroid enlargement presenting to the endocrinology clinic. They are used to detect upper airway obstruction ( UAO ) secondary to tracheal compression ( TC ) from a goitre. Surgical assessment in contrast tends to focus on clinical evaluation supplemented when required by imaging. The aim of this study was to investigate whether FVL s influence the decision to operate in patients with a goitre. Methods We identified patients with a goitre referred by the department of endocrinology for FVL s between 2006 and 2011. The results of the FVL were collated, and their impact on patient management was assessed. Results Ninety‐six patients were referred for FVL . In 38 patients, the indication was specifically to evaluate the effects of a goitre. Of these, 33 were reported as normal. Five FVL s were reported as abnormal (3 suggesting lung pathology and 2 TC ). Both patients with TC on FVL presented no CT evidence of TC and underwent surgery due to abnormal cytology. Of the 33 normal FVL s, 7 underwent surgery: 2 for local compression, 4 for abnormal cytology and 1 for Graves' disease. None of the FVL s influenced the decision to operate. Conclusion FVL s may detect subradiological TC , but rarely influence management in patients with a goitre. In view of this and the cost of £235 per investigation, FVL should be reserved for goitre patients with suspected primary lung pathology, where the distinction between large and small airway compression is likely to influence management.