The Effect of Thyroid Surgery on the Accuracy of Palpation-Based Cricothyroid Membrane Identification in Female Patients: A Prospective Observational Cohort Study

TL;DR

Thyroid surgery in women reduces the accuracy of finding the cricothyroid membrane by touch, according to a study using ultrasound validation.

Contribution

The study shows that prior thyroid surgery significantly impairs palpation accuracy for CTM identification in female patients.

Findings

Control group had a 90% success rate in CTM identification, while the thyroid surgery group had 42.5%.

Sensitivity and specificity of CTM palpation were 42.5% and 10% in patients with thyroid surgery history.

Thyroid surgery history may require revised clinical practices for airway management training in female patients.

Abstract

Background and Objectives: This study examined how a history of thyroid surgery impacts the precision of cricothyroid membrane (CTM) identification through palpation (validated by ultrasound) in female patients visiting the operating room for surgeries unrelated to neck procedures. Materials and Methods: This prospective observational cohort study enrolled adult female patients undergoing elective non-neck surgery, dividing them into control (no thyroid surgery history; n = 40) and experimental (with thyroid surgery history; n = 40) groups. CTM identification was performed by palpation and confirmed via ultrasound. Results: There were no significant differences between two groups in the demographic characteristics of the patients. The success rate and accuracy of CTM identification through palpation were significantly higher in the control group compared to the experimental group (90% vs. 42.5%, respectively; p < 0.001). For female patients with a history of thyroid surgery, the sensitivity of successful CTM palpation was 42.5%, and the specificity was 10%. These figures are based on the calculated true positives (17), false positives (36), true negatives (4), and false negatives (23). Conclusions: Thyroid surgery history in female patients may hinder the accurate palpation-based identification of the CTM, suggesting a need for enhanced clinical practices and considerations during airway management training.

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