Bagcilar Medical Bulletin (Dec 2020)
Pulmonary Function Test and Thoracic Computed Tomography in the Evaluation of Dyspnea in Patients with Goiter
Abstract
Objective:The uses of flow volume loop (FVL) section of pulmonary function test (PFT) and thorax computed tomography (TCT) are examined in the evaluation of dyspnea, which is one of the leading symptoms of compression due to goiter.Method:Thirty-six patients who were admitted to the Chest Diseases and Tuberculosis Clinic of University of Health Sciences Turkey, Bağcılar Training and Research Hospital between August 2019 and January 2020 with the complaint of dyspnea and who were diagnosed with goiter were enrolled in this prospective study. To determine the compression of the goiter on the trachea, PFT and TCT were performed in all cases. The patients were evaluated in terms of age, gender, smoking history, complaints, respiratory system physical examination findings, FVL, type of goiter, presence of TCT findings of external compression and deviation of trachea due to goiter. The degree of external compression on trachea according to the TCT were grouped as follows grade 0: No compression on the trachea, grade 1: Compression narrowing the tracheal lumen diameter less than 50%, grade 2: Compression narrowing the tracheal lumen diameter more than 50%. FVL in PFT was grouped as normal and upper airway obstruction (UAO).Results:Twenty-six of the 36 cases were female (72.22%). The median age was 54.50 (range, 32-80) years. When the location of the goiter was evaluated, it was found that 25 (69.44%) of the cases had retrosternal goiter (RSG) and 11 (30.56%) had cervical goiter (CG). In terms of FVL, 28 (77.78%) were compatible with UAO and 8 (22.22%) with normal condition. Tracheal deviation was detected in 18 (50%) cases. External compression of trachea was detected in 28 (77.78%) cases, grade 1 in 14 (38.89%) cases and Grade 2 in 14 (38.89%) cases. FVL was found to be compatible with UAO in grade 0, 1, and 2 with the percentages of 25%, 85.71%, and 100%, respectively (p=0.0001). Normal FVL appearance in Grade 0 group was statistically significant when compared to grade 1 and grade 2 (p=0.001). According to goiter type, the compatibility of FVL with UAO was higher in the RSG group with a statistical significance (p=0.002).Conclusion:Although TCT is useful in evaluating the boundaries of the disease and surgical anatomy in patients with goiter, preoperatively, the FVL of the PFT should be considered as a priority over TCT to support the clinical correlation of dyspnea due to goiter.
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