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VOLUME 14 , ISSUE 3 ( September-December, 2022 ) > List of Articles

Original Article

Study of Correlation of Clinical Findings and Operative Findings in Thyroid Swellings: A Retrospective Hospital-based Study

Suvamoy Chakraborty, Manu Coimbatore Balakrishnan, Vandana Raphael, Barishisha Kharkongor, Ratan Medhi

Keywords : Assessment, Biopsy, Clinical skill, Goiter, Retrospective studies, Risk, Thyroid neoplasms, Thyroid nodule

Citation Information : Chakraborty S, Balakrishnan MC, Raphael V, Kharkongor B, Medhi R. Study of Correlation of Clinical Findings and Operative Findings in Thyroid Swellings: A Retrospective Hospital-based Study. Int J Otorhinolaryngol Clin 2022; 14 (3):95-99.

DOI: 10.5005/jp-journals-10003-1408

License: CC BY-NC 4.0

Published Online: 20-03-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Introduction: Clinical evaluation plays an important role in diagnosing thyroid malignancy. However, it is largely dependent on the experience of the clinician to have an index of suspicion to detect malignancy and to channel further investigations. Not many studies have been done to signify the use of clinical and intraoperative findings in predicting thyroid malignancy. Objective: The objective of the article was to study the correlation of clinical findings and operative findings in thyroid swellings with histopathological examination (HPE) reports in the Northeastern Indian population in a tertiary care hospital. Materials and methods: The retrospective cohort study was conducted in the department of otorhinolaryngology (ENT). Case records of patients who visited department of ENT with thyroid swellings in the year 2017–2020 were included in the study. Results: A total of 67 patients were included in the study. Clinically, the most common diagnosis was solitary thyroid nodule (STN) made in 54 (81%) patients. In our study, the clinical examination had a sensitivity of 83%, specificity of 32%, positive predictive value (PPV) of 59%, and negative predictive value (NPV) of 63% in diagnosing thyroid malignancy. The intraoperative assessment had a sensitivity of 100%, specificity of 20%, PPV of 59%, and NPV of 100% in diagnosing thyroid malignancy. Conclusion: Clinical evaluation forms the foundation stone for further evaluation of thyroid disorders. Even though a lot of advancements have been made in management of thyroid disorders, clinical evaluation should not be overlooked. With clinical examination having a sensitivity of 83% and NPV of 63% and intraoperative assessment having a sensitivity of 100% and NPV of 100%, it helps in ruling out thyroid malignancy in our study population. However, studies with a large sample size are required to further validate the statement. Clinical significance: Due importance should be given to high-risk clinical and intraoperative features for early diagnosis of thyroid cancer in any population.


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  1. Watkinson JC, Clarke RW, editors. Scott-Brown's otorhinolaryngology and head and neck surgery. 8th ed. vol. 1. Florida: CRC Press; 2018.
  2. Hegedüs L, Bonnema SJ, Bennedbæk FN. Management of simple nodular goiter: current status and future perspectives. Endocr Rev 2003;24(1):102–132. DOI: 10.1210/er.2002-0016.
  3. Perros P, Boelaert K, Colley S, et al. Guidelines for the management of thyroid cancer. Clin Endocrinol (Oxf) 2014;81:1–122. DOI: 10.1111/cen.12515.
  4. Chauhan HH, Aiyer RG, Shah PC. Clinical, pathological and radiological correlation of thyroid swellings. Int J Otorhinolaryngol Head Neck Surg 2020;6(4):708. DOI: 10.18203/issn.2454-5929.ijohns20201287.
  5. Thyroid History Timeline [Internet]. American Thyroid Association. Available from: https://www.thyroid.org/about-american-thyroid-association/clark-t-sawin-history-resource-center/thyroid-history-timeline/.
  6. Nix P, Nicolaides A, Coatesworth AP. Thyroid cancer review 1: presentation and investigation of thyroid cancer. Int J Clin Pract 2005;59(11):1340–1344. DOI: 10.1111/j.1368-5031.2005.00671.x.
  7. Durante C, Grani G, Lamartina L, et al. The diagnosis and management of thyroid nodules: a review. Journal of the American Medical Association 2018;319(9):914. DOI: 10.1001/jama.2018.0898.
  8. Chaudhary M, Baisakhiya N, Singh G. Clinicopathological and radiological study of thyroid swelling. Indian J Otolaryngol Head Neck Surg 2019;71:893–904. DOI: 10.1007/s12070-019-01616-y.
  9. Pasha H, Mughal A, Wasif M, et al. The efficacy of Bethesda system for prediction of thyroid malignancies–a 9 year experience from a tertiary center. Iran J Otorhinolaryngol 2021;33(117):209. DOI: 10.22038/ijorl.2021.50538.2687.
  10. Raniwala A, Wagh D, Dixit-Shukla A, et al. Study and correlation of clinical, radiological, cytological, and histopathological findings in the diagnosis of thyroid swellings. J Datta Meghe Inst Med Sci Univ 2017;12(2):138. DOI: 10.4103/jdmimsu.jdmimsu_61_17.
  11. Al-Sharafi BA, AlSanabani JA, Alboany IM, et al. Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic. Thyroid Res 2020;13:8. DOI: 10.1186/s13044-020-00082-x.
  12. Gautam H, Kumar V, Kanaujia S, et al. Clinico-cytoradiological correlation of thyroid surgery in patients with thyroid nodule. Ann Indian Acad Otorhinolaryngol Head Neck Surg 2017;1(2):17. DOI: 10.4103/aiao.aiao_7_17.
  13. Bhartiya R, Mallik M, Kumari N, et al. Evaluation of thyroid lesions by fine-needle aspiration cytology based on Bethesda system for reporting thyroid cytopathology classification among the population of South Bihar. Indian J Med Paediatr Oncol 2016;37(4):265. DOI: 10.4103/0971-5851.195742.
  14. Nguyen QT, Lee EJ, Huang MG, et al. Diagnosis and treatment of patients with thyroid cancer. Am Health Drug Benefits 2015;8(1): 30–40. PMID: 25964831.
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