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

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.